实施改良捆绑式护理对早期发现和预防呼吸机相关肺炎的影响

Safaa Sayed, Hadeer El Kenany, Samah Ahmed, Zainab Allam
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摘要

背景:使用机械呼吸机的重症患者经常会患上呼吸机相关性肺炎,这种肺炎具有破坏性影响,如延长机械通气时间、延长住院时间和增加死亡率。研究目的:评估在重症监护病房实施改良护理包对早期发现和预防呼吸机相关肺炎的影响。设计 :准实验研究设计。研究地点坦塔大学医院附属急诊医院麻醉科重症监护室、创伤科和急诊科重症监护室。研究对象方便取样,选取在选定环境中住院的 60 名成年重症患者,将其平均分为两组,每组 30 人(对照组和研究组)。工具:使用三种工具,工具 I:机械通气患者评估,工具 II:四分意识水平量表,工具 III:呼吸机相关肺炎评估指标:采用改良呼吸机捆绑包后,研究组和对照组的 VAP 发生率差异非常明显(P=0.000)。干预第 7 天后,对照组 VAP 发生率为 76.67%,而研究组仅为 23.33%,差异显著(P=0.00)。结论应用改良呼吸机捆绑包对预防和减少 VAP 的发生率有好处。建议
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Effect of Implementing Modified Bundle of Care on Early Detection and Prevention of Ventilators Associated Pneumonia
Background : Critically ill patients with mechanical ventilator frequently experience ventilator associated pneumonia, which has devastating effects such as prolongation of mechanical ventilation, increase length of hospital stay, and increase mortality rate. Aim of study to evaluate the effect of implementing modified bundle of care on early detection and prevention of ventilator associated pneumonia in intensive care unit. Design : Quasi-experimental research design. Setting: Anesthesia Intensive Care Unit, Traumatology and Emergency Medicine Intensive Care Unit of Emergency hospital affiliated to Tanta University hospital. Subjects: A convenience sampling of 60 adult critically ill patients who admitted to the selected setting and divided into two equal groups; 30 patients in each (control and study groups). Tools: three tools were used, Tool I: Mechanically Ventilated Patients Assessment, tool II Four Score Level of Consciousness Scale and tool III Indicators of Ventilator associated pneumonia Assessment Results: A highly significant difference was detected between the study and control groups regarding VAP incidence after applying modified ventilator bundle which (P=0.000). The incidence of VAP was 76.67% in the control group compared with only 23.33% in study group after the 7 th day of intervention with significant differences in which (P=0.00). Conclusion: Applying modified ventilator bundle had beneficial effect on preventing and decrease the incidence of VAP. Recommendation
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