Effect of "disease-characteristics nursing quality improvement" program combined with targeted monitoring in reducing the incidence of VAP among patients with mechanical ventilation
10.3760/cma.j.issn.1674-2907.2017.02.007
- VernacularTitle:"一病一品"项目联合目标性监测降低机械通气患者VAP发生率的实践效果
- Author:
Cui YUAN
1
;
Meihua HU
;
Shuangling LI
;
Yanming DING
;
Lan WANG
;
Yanchun ZHAO
Author Information
1. 100034,北京大学第一医院重症医学科
- Keywords:
Respiration;
artificial;
Pneumonia;
ventilator-associated;
Targeted monitoring;
Disease-characteristics nursing quality improvement program
- From:
Chinese Journal of Modern Nursing
2017;23(2):175-179
- CountryChina
- Language:Chinese
-
Abstract:
Objectives To evaluate the effects of "disease-characteristics nursing quality improvement" program(DNQIP)combined with targeted monitoring in reducing the incidence of ventilator associated pneumonia (VAP)among patients with mechanical ventilation and to provide evidence for the prevention of VAP. Methods This was a prospective intervention study. All mechanical ventilation patients admitted in stroke intensive care unit(SICU)of our hospital from 2007 to 2015 were selected as the research object. Targeted monitoring was implemented in patients admitted from 2007 to 2011,and DNQIP was formed based on the monitoring results. DNQIP combined with targeted monitoring was implemented from 2012 to 2013 as the first phase,and the second phase was from 2014 to 2015.Results From 2007 to 2015,the number of new patients per year and the total time of using breathing machine in SICU presented a tendency of increasing while the number of patients with VAP and the incidence of VAP presented a tendency of decreasing year by year. The implementation of DNQIP in the first phase from 2012 to 2013(incidence of VAP was 5.4 ‰),compared with the data before implementation from 2007 to 2011(incidence of VAP was 13.8‰),the incidence of VAP was significantly reduced(χ2=9.029,P=0.003). The incidence of VAP(5.3‰)in the second phase from 2014 to 2015,was significantly reduced compared with the incidence of VAP(13.8‰)from 2007 to 2011(χ2=9.559, P=0.002).Conclusions The implementation of targeted monitoring is helpful in finding problems existing in the prevention of VAP. DNQIP in patients with mechanical ventilation can effectively reduce the incidence of VAP and can refine professional assessment and health education. It is also good for the standardization and evidence-based care in the whole process provided for patients. DNQIP combined with targeted monitoring can realize the continuous quality improvement on the basis of evidence-based theory.
