四川省二三级医疗机构呼吸机使用与管理现状调查  

Investigation on ventilator use and management in secondary and tertiary medical institutions in Sichuan Province

作　　者：梁拯华 王思美 刘秋玉 许金龙 刘泽芳 文丹 LIANG Zheng-hua;WANG Si-mei;LIU Qiu-yu;XU Jin-long;LIU Ze-fang;WEN Dan(Department of Critical Care Medicine,Mianyang Central Hospital,Mianyang 621000,Sichuan Province,China)

机构地区：[1]绵阳市中心医院重症医学科,四川绵阳621000

出　　处：《医疗卫生装备》2025年第3期75-80,共6页Chinese Medical Equipment Journal

基　　金：四川省卫生信息学会课题(2024007);国家卫生健康委医院管理研究所医疗质量(循证)管理研究项目(YLZLXZ24G037)

摘　　要：目的:调查四川省二三级医疗机构呼吸机使用与管理现状,为科学管理与系统培训呼吸机使用人员提供参考。方法:对四川省13所二三级医疗机构的235名护士进行问卷调查,调查内容包括调查对象的一般资料、呼吸机管路连接及基本参数设置、呼吸机的清洁消毒与维护、呼吸机报警识别及处理和院感防控等。结果:调查结果显示,20.4%的调查对象为重症专科护士,79.6%的调查对象参加过科室内呼吸机使用培训。91.9%的调查对象表示,在呼吸机开机后会连接模拟肺进行自检;66.4%的调查对象表示,呼吸机的初始参数由医生设定;60.9%的调查对象表示,呼吸机的性能监测与常规维护由护士完成;63.4%的调查对象表示,科室常用呼吸机管路为一次性管路。89.8%的调查对象表示,呼吸机日常消毒及管理主要由护士完成;46.0%的调查对象表示,呼吸机外部表面消毒方式主要使用伽马消毒湿纸巾;44.7%的调查对象表示,会每天进行呼吸机外部消毒;48.5%的调查对象表示,会对呼吸机内部气路实施消毒;57.0%的调查对象表示,会在每个患者使用呼出流量传感器后进行消毒。74.5%的调查对象表示关注过呼吸机波形,调查对象中通过呼吸机波形判断回路内是否有分泌物或积水的正确率仅为21.3%,通过呼吸机波形判断回路是否漏气的正确率仅为22.1%。59.1%的调查对象表示,会每24 h更换1次密闭式吸痰管;71.1%的调查对象表示,会使用专用压力测量仪进行气囊压力监测。结论:四川省二三级医疗机构大部分护士能正确使用呼吸机,但存在呼吸机清洁消毒规范不统一、感染防控措施不规范、部分临床护士对呼吸机波形识别能力不足等问题,建议院方加强相关培训,以提升临床护理人员对呼吸机的管理水平。Objective To investigate the current situation of the ventilator use and management in secondary and tertiary medical institutions in Sichuan Province to provide references for management and training of ventilator users.Methods A questionnaire survey involving in 235 nurses from 13 secondary and tertiary medical institutions in Sichuan Province was conducted in terms of general information of the respondents,pipeline connection and parameter setup of ventilators,cleaning,sterilization and maintenance of ventilators,identification and treatment of ventilator alarms and hospital-acquired infection prevention and control.Results The results showed 20.4% of the respondents were nurses from critical care departments,and 79.6% of the respondents underwent the training for using the ventilator in their department;91.9% of the respondents could conduct ventilator self-testing by connecting the simulated lungs after the ventilator was switched on;66.4% of the respondents indicated that the initial parameters of the ventilator were set by the doctor;60.9% of the respondents proved that the performance monitoring and routine maintenance of the ventilator were carried out by the nurse;63.4% of the respondents showed disposable lines were commonly used in the departments.There were 89.8% of the respondents said the daily sterilization and management of the ventilator were performed by the nurse;46.0% of the respondents expressed the external surface of the ventilator was disinfected mainly with gamma disinfectant wipes;44.7% of the respondents indicated the external surface of the ventilator was sterilized every day;48.5% of the respondents said the internal airway of the ventilator was disinfected;57.0% of the respondents proved the disinfection was conducted after the expiratory flow sensors were used by any patient.There were 74.5% of the respondents that had paid attention to the ventilator waveform,and by the ventilator waveform only 21.3% were correct in determining whether there was secretion or fluid in the circuit a

关 键 词：呼吸机 呼吸机管理 呼吸机使用 二三级医疗机构 四川省 

分 类 号：R318.6[医药卫生—生物医学工程] TH777[医药卫生—基础医学]