应用临床护理路径技术对全麻术后气管导管病人预防呼吸机相关性肺炎(VAP)的研究(1)
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[摘要] 目的 探讨临床护理路径应用于全麻术后气管导管病人中预防VAP的效果。方法 将150名全麻术后病人随机分为试验组和对照组。对照组77例，采用传统全麻术后气管导管护理方法，试验组73例，采用临床护理路径行全麻术后气管导管护理。拔管后进行临床护理效果的评价。结果 与传统护理方法相比，采用临床路径护理的病人不但降低了住院时间及医疗费用，提高了护理质量满意度和术后自理能力恢复率，而且缩短了机械通气时间，使得 VAP的发生率明显降低。结论 临床护理路径应用于全麻术后气管导管病人能使病人得到行之有效的气管导管护理，预防VAP发生，而且全面系统的气管导管还提高了护士工作的主观能动性及护理工作的目标性和计划性。
[关键词] 临床护理路径 全麻术后病人 呼吸机相关性肺炎(VAP)
[中图分类号] R197.39[文献标识码] A[文章编号] 1005-0515(2011)-08-013-02
Application Of Clinical Nursing Pathway For Prevention Of Ventilator Associated Pneumonia
Of trachea Cannula After General Anesthesia
[Abstract] Objective To assess the effect of clinical nursing pathway for prevention of ventilator associated pneumonia of trachea cannula after general anesthesia.Methods 150 patients were divided into two groups randomly.77 cases received traditional nursing standards of trachea cannula after general anesthesia as controls,73 cases received clinical nursing pathway standards of trachea cannula after general anesthesia. All patients were assessed the clinical nursing effect after tracheal vessel exelcymosis.Results Compared with control group,clinical nursing pathway standards not only reduce days of hospitalization and costs,enhance functional rehabilitation and degree of satisfaction at quality of nursing care,but also shorten retention time of tracheal vessel.VAP incidence was lower in trial group than control. Conclusion Application of clinical nursing pathway for trachea cannula after general anesthesia can not only make a improved nursing for patients with trachea cannula and prevent ventilator associated pneumonia,but also promote nurses' motivation and objective and planning of nursing.
[Keywords] Clinical nursing pathway； Patient after general anesthesia； Ventilator associated pneumonia
临床护理路径作为一种科学高效的护理模式，可以将护理工作标准化，使临床治疗及护理有序进行、缩短住院天数、减少漏项、提高管理质量，为病人提供高效的服务[1]。呼吸机相关性肺炎(Ventilator Associated Pneumonia，VAP)是机械通气患者最主要的医院获得性感染[2],会延长患者的机械通气时间、重症监护病房住院日及总住院时间，增加医疗费用[3-4]。应用临床护理路径于全麻术后气管插管病人的护理中，对病人进行有目标、有计划、有步骤的全面护理，来预防VAP发生，国内外未见相关报道。笔者于2008年1月至2008年12月将临床护理路径应用于全麻术后采取机械通气的病人中，来研究其对VAP预防效果。现报告如下。
1 资料与方法
1.1 一般资料 选择2008年1月至2008年12月我院需气管插管全麻手术病人150例，男性89例，年龄23-67岁，平均年龄54岁；女性61例，年龄20-70岁，平均年龄58岁 ......
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