综合干预策略对机械通气患者床头抬高实施效果影响.docVIP

综合干预策略对机械通气患者床头抬高实施效果的影响 　　[摘要] 目的 探讨综合干预策略对提高护士在执行机械通气患者床头抬高30°～45°的实施率及实施效果。 方法 选取惠州市中心人民医院2013年1月～2014年6月在呼吸重症监护室（ICU）40例机械通气、检查例次750次的患者为干预组，实施干预策略。组织护士培训、制订操作指引、宣传图；对护士执行床头抬高进行持续有效的质控管理；加强患者的管理提高患者体位认知度等综合干预策略，提高机械通气患者床头抬高30°～45°的实施。选取2013年1月～2014年6月急诊ICU 36例机械通气、检查例次736次的患者为对照组。对照组患者按集束化呼吸机相关肺炎（VAP）预防护理措施要求安置体位。观察床头抬高实施率、并发症发生率，并进行统计学分析。 结果 对照组床头抬高30°～45°实施率43.4%，干预组床头抬高30°～45°实施率为68.8%，且干预组的肺部并发症低于对照组。 结论 综合干预策略能提高机械通气患者床头抬高率的实施，降低机械通气患者的肺部并发症 [关键词] 机械通气；呼吸机相关性肺炎；床头抬高；体位；并发症 [中图分类号] R248.1 [文献标识码] A [文章编号] 1673-7210（2016）07（a）-0056-04 [Abstract] Objective To investigate the effect of comprehensive intervention strategy on the improvement of nurses’ implementation of elevating the head of bed to 30°-45° during the course of mechanical ventilation， and study the benefits of the comprehensive intervention strategy. Methods 40 cases of mechanical ventilation in the respiratory intensive care unit （ICU） Huizhou Central People’s Hospital from January 2013 to June 2014 were selected， the cases checked for 750 times were the intervention group， intervention strategies were conducted， training of nurses was organized， operational guidelines and publicity plan were developed， head up the implementation of continuous and effective quality control management for nurses were conducted； the management of patients to improve patient awareness of posture was strengthened and other comprehensive intervention strategy was to improve bedside mechanically ventilated patients elevation 30°-45° implementation. 36 cases of mechanical ventilation from January 2013 to June 2014 in ICU were selected， inspection times of 736 cases of patients in the control group. Placement position of the patients in the control group VAP bundle was according to preventive care measure requirements. Head up implementation rate， complication rate were observed and statistical analysis was conducted. Results The rate of implementation of elevation the head of bed to 30°-45° in control group was