VAP集束化护理方案实施缺陷的相关因素分析
Relative factors on implementation defect of bundle care program in ventilator-associated pneumonia
目的 探讨气管插管患者VAP预防集束化护理方案实施缺陷的相关因素.方法 收集2015年1—6月北京某三甲医院内科ICU收治的72例气管插管患者的临床资料,按照是否存在集束化护理方案实施缺陷分为两组,缺陷组30例和非缺陷组42例,分析发生实施缺陷的相关因素.结果 缺陷组患者Glasgow评分为(10.70±3.91)分,高于非缺陷组,差异有统计学意义(t=2.434,P=0.017);缺陷组CRRT应用比例占50%,高于非缺陷组,差异有统计学意义(x2=6.429,P=0.011);缺陷组的护患比为(0.46±0.03)分,低于非缺陷组,差异有统计学意义(t=-2.060,P=0.043).多因素分析显示,Glasgow评分高、CRRT应用、护患比偏低是发生VAP预防集束化护理措施实施缺陷的危险因素(P<0.05).结论 VAP集束化护理方案实施缺陷不仅受工作人员个人知信行影响,还有许多来自患者和环境中的客观因素,管理者应当以积极的态度应对,从而改善护理结局.
更多Objective To explore the relative factors on implementation defect of bundle care program in prevention of ventilator-associated pneumonia(VAP) in patients with endotracheal intubation.Methods The clinical data of 72 patients with endotracheal intubation in medical intensive care unit(MICU) of a classⅢ grade A hospital in Beijing from January 2015 to June 2015 were collected. They were divided into the group of defect(n=30) and the group of non-defect(n=42) according to the existence of implementation defect of bundle care program. The relative factors of implementation defect were analyzed.Results The score of Glasgow was (10.70±3.91) in the group of defect, which was higher than that in the group of non-defect(t=2.434, P=0.017). The proportion of application of CRRT was 50% in the group of defect higher than that in the group of non-defect(x2=2.434,P=0.011). The nurse-patient ratio was (0.46±0.03) in the group of defect lower than that in the group of non-defect(t=2.060,P=0.043). The multi-factor analysis showed the high score of Glasgow, application of CRRT and low nurse-patient ratio was the risk factors of the occurrence of implementation defect of bundle care program in prevention of VAP(P<0.05).Conclusions The implementation defect of bundle care program in precaution of VAP is affected not only by the knowledge-attitude-practice of staff,but also by many objective factors from patients and environment. The managers should reply with a positive attitude so as to improve nursing outcomes.
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