Investigation and analysis of nursing prevention and control of ventilator-associated pneumonia in ICUs of 194 tertiary hospitals
10.3761/j.issn.0254-1769.2023.21.008
- VernacularTitle:194所三级医院ICU呼吸机相关性肺炎护理实践现状与对策
- Author:
Xin SHAO
1
;
Xia WANG
;
Chenxia LIU
;
Juyuan LIU
;
Meng CAI
;
Na BU
;
Lu KUANG
Author Information
1. 100730 北京市 北京医院重症医学科/国家老年医学中心/中国医学科学院老年医学研究院
- Keywords:
Intensive Care Units;
Ventilator-Associated Pneumonia;
Infection Control;
Nursing Care
- From:
Chinese Journal of Nursing
2023;58(21):2617-2623
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the nursing clinical practice of ICU ventilator-associated pneumonia(VAP)prevention and control of tertiary hospitals in China,and analyze relevant countermeasures.Methods A self-designed questionnaire consisted of 3 parts and 26 items.A questionnaire survey was conducted among nurses in 380 ICUs in 194 tertiary hospitals in 26 provinces from September 1 to 15,2021,using the convenient sampling method.Results A total of 380 valid questionnaires were collected,with an effective rate of 100%.In the system process,369(97.11%)ICUs had files to prevent VAP;291(76.58%)ICUs had a checklist of measures to prevent VAP clustering;274(72.11%)ICUs had continuous improvement projects about VAP in the last 3 years.In the aspect of body position management,semi-decubitus position was the first choice for the patients with invasive mechanical ventilation of 338(88.95%)ICUs.For nursing operation,224(58.95%)ICUs used Subglottic suction,and 128(33.68%)among them used air shock to remove the retention on the balloon;normal saline is still routinely injected before sputum aspiration in 72(18.95%)ICUs.In terms of balloon pressure monitoring,253(66.58%)ICUs did the oral care 3-4 times a day.In the balloon pressure monitoring,313(82.37%)ICUs use airbag pressure gauges to intermittently monitor airbag pressure;293(77.11%)ICUs replaced the ventilator pipeline once a week.There are significant differences in the current practice status of different types of ICUs in terms of compliance strategies for bed head lifting,subglottic secretion drainage,airbag pressure monitoring,and oral care(P<0.05).Conclusion At present,the relevant systems and procedures to prevent VAP have been improved,but the specific prevention and control measures need to be further unified.Therefore,it is suggested to analyze the weak links of VAP nursing prevention and control practice in various medical structures,carry out relevant training and quality control for the weak links,and further improve the working mechanism of continuous quality improvement,thus effectively reduce the incidence of VAP.
