Applying evidence-based prevention bundle strategies of ventilator-associated pneumonia in ventilated neonates
10.3760/cma.j.issn.2096-2932.2018.05.004
- VernacularTitle:基于证据的预防呼吸机相关性肺炎集束化策略在新生儿的临床应用
- Author:
Xiaojing HU
1
;
Xiaoting ZHU
;
Ruyi ZHENG
;
Liling LI
;
Li WANG
;
Yuxia ZHANG
;
Yun CAO
;
Wenhao ZHOU
Author Information
1. 复旦大学附属儿科医院新生儿科
- Keywords:
Pneumonia,ventilator-associated;
Evidence-based nursing;
Bundle;
Mechanical ventilation
- From:Chinese Journal of Neonatology
2018;33(5):334-338
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the clinical effect of evidence-based prevention strategies of ventilator-associated pneumonia (VAP) in newborns with endotracheal intubation in neonatal intensive care unit (NICU).Method A retrospective analysis was carried out in neonates undergoing mechanical ventilation,who were admitted to the NICU of the hospital from 2016 to 2017.Intubated newborns from January 2016 to December 2016 were conducted with traditional method of preventing VAP and included as control group.While intubated newborns admitted from January 2017 to December 2017 with newly developed evidence-based prevention strategy for VAP were included as observation group.The positive rates of culture from swab or sputum or endotracheal intubation tube ends obtained within 48 hours after intubation and 48 hours after extubation were compared between groups.The neonates whose swab or sputum culture was negative before intubation were included.The positive rate was presented as the number of positive cases/1 000 intubation days.Result A total of 1 221 intubated infants were included,with 632 cases in the control group which were intubated 798 times,and 589 cases in the observation group which were intubated 720 times.The gestational age and birth weight of the observation group was lower than the control group.The rate of extremely low birth weight infant of the observation group was higher than that of the control group.The mechanical ventilation days were also longer in the observation group.The differences were statistically significant (P ＜ 0.05).In the control group,the number of positive cases was 112 and the total intubation days were 3 079 days,the positive rate was 36.4 cases/1 000 intubation days.In the observation group,the number of positive cases was 72 and the total intuhation days were 3 475 days,the positive rate was 20.7 cases/1 000 intubation days.The positive rate of observation group was lower than the control group,the differences was statistically significant (x2 =4.060,P =0.044).Conclusion Evidence-based neonatal VAP bundle can reduce the invasion of respiratory pathogenic bacteria in NICU.In the future work of NICU nursing,we should use bundle strategy to care for babies more and more,and the bundle should be supported by evidence.
