Clinical practice of multidimensional strategy to reduce neonatal ventilator-associated pneumonia
10.3969j.issn.1000-3606.2015.05.012
- VernacularTitle:综合干预策略降低新生儿呼吸机相关性肺炎的效果评估
- Author:
Heng SHU
;
Hong WEI
;
Jie LI
;
Chuanlong ZHANG
;
Qiong XU
- Publication Type:Journal Article
- Keywords:
mechanical ventilation;
ventilator-associated pneumonia;
infection;
neonate
- From:
Journal of Clinical Pediatrics
2015;33(5):445-449
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the interventional effect of multidimensional strategy to reduce the incidence of neonatal ventilator-associated pneumonia.Methods The patients who were admitted to the NICU department and received mechanical ventilation (MV) for more than 48 hours from October 2012 to September 2014 were recruited. The control group received the experienced interventions from October 2012 to September 2013, neonates from October 2013 to September 2014 were recruited as the intervention group receiving multidimensional controlling strategy, including bundle care, education, pro-cess and outcome surveillance and feedback on the practices. The compliance of before-after implementation of interventions were quantitatively evaluated,and the rate of VAP was compared between the two groups.Results The compliance rate of hand hygiene and the qualiifed rate of sputum suction, oral care, drain condensation from ventilator circuit, semi-recumbent posi-tion, and preventing of stress-ulcers were increased 17.0%, 11.4%, 14.7%, 18.2%, 37.5% and 56.3% respectively after implemen-tation of multidimensional strategy, and had statistical difference (χ2=36.47-294.36,P<0.01). But the qualiifed rate of antibiotic use only was 66.1% in the post-VAP bundle phases, and showed no statistical difference before and after(P>0.05). The VAP rate was 41.7 cases per 1000 MV-days during control group and 19.7 cases per 1000 MV-days during intervention group, had statis-tical signiifcance (P<0.05). But the rate of ventilator application showed no statistical difference between two group (P>0.05). ConclusionThe multidimensional strategy can effectively prevent the incidence of VAP.
