集束化护理干预对COPD患者呼吸道多重耐药菌感染的防控效果
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摘要
目的探讨集束化护理干预在慢性阻塞性肺疾病(COPD)患者多重耐药菌感染防控中的应用效果。方法选取2016年9月至2018年10月住院治疗的COPD患者107例,早期(2016年9月至2017年9月)采用常规护理的52例患者为常规组,后期(2017年10月至2018年10月)采用集束化护理模式的55例患者为试验组。记录2组患者的院内多重耐药菌感染率、医护人员护理措施的执行情况以及患者的护理满意度和住院时间。结果试验组患者的多重耐药菌感染率为12.73%较常规组的34.62%显著下降(P<0.05)。试验组医护人员手卫生抽检合格率为92.73%、隔离护具使用率为89.09%、房间或床位隔离率为100%、诊疗设备专人专用率为96.36%、物品消毒合格率为94.66%和家属掌握防感染措施率为85.45%均明显高于常规组(P均<0.05)。与常规组比较,试验组患者的护理满意度得分显著提高,而住院时间显著缩短,差异有统计学意义(均P<0.05)。结论对COPD患者采取集束化护理干预,能够有效防控多重耐药菌感染,提高医护人员护理措施执行效果和患者的护理满意度,缩短治疗时间。
Objective To explore the application effects of cluster nursing intervention in prevention and control of multiple drug-resistant bacterial infections in patients with chronic obstructive pulmonary disease(COPD).Methods A total of 107 patients with COPD who were admitted and treated in our hospital from September 2016 to October 2018 were enrolled in the study.The 52 patients who received routine nursing at early period(September 2016 to September 2017) were enrolled as routine treatment group, and the other 55 patients who were treated by cluster nursing intervention at late period(October 2017 to October 2018) were enrolled as experimental group.The infection rate of multi-drug resistant bacteria in hospital,the implementation of nursing measures of medical staff,the satisfaction degree of patients and hospitalization time were observed and compared between the two groups.Results The infection rate of multidrug-resistant bacteria in experimental group was 12.73%,which was significantly lower than that(34.62%) in routine treatment group(P<0.05). In experimental group,the qualified rate of hand hygiene sampling examination in experimental group was 92.73%,and the use rate of isolation protective devices was 89.09%,the isolation rate of rooms or beds was 100%,and the special rate of diagnostic and therapeutic equipment was 96.36%,the qualified rate of disinfection of articles was 94.66% and the rate of family members mastering anti-infection measures was 85.45%,which in experimental group were significantly higher than those in routine treatment group(P<0.05).Moreover the scores of nursing satisfaction degree in experimental group were significantly higher than those in routine treatment group(P<0.05),however,the length of staying in hospital in experimental group were significantly shorter than that in routine treatment group(P<0.05).Conclusion The cluster nursing intervention for patients with COPD can effectively prevent and control multi-drug resistant bacterial infection,improve the effects of nursing measures implemented by medical staff and improve patients' satisfaction degree,moreover,which can shorten the treatment duration.
Objective To explore the application effects of cluster nursing intervention in prevention and control of multiple drug-resistant bacterial infections in patients with chronic obstructive pulmonary disease(COPD).Methods A total of 107 patients with COPD who were admitted and treated in our hospital from September 2016 to October 2018 were enrolled in the study.The 52 patients who received routine nursing at early period(September 2016 to September 2017) were enrolled as routine treatment group, and the other 55 patients who were treated by cluster nursing intervention at late period(October 2017 to October 2018) were enrolled as experimental group.The infection rate of multi-drug resistant bacteria in hospital,the implementation of nursing measures of medical staff,the satisfaction degree of patients and hospitalization time were observed and compared between the two groups.Results The infection rate of multidrug-resistant bacteria in experimental group was 12.73%,which was significantly lower than that(34.62%) in routine treatment group(P<0.05). In experimental group,the qualified rate of hand hygiene sampling examination in experimental group was 92.73%,and the use rate of isolation protective devices was 89.09%,the isolation rate of rooms or beds was 100%,and the special rate of diagnostic and therapeutic equipment was 96.36%,the qualified rate of disinfection of articles was 94.66% and the rate of family members mastering anti-infection measures was 85.45%,which in experimental group were significantly higher than those in routine treatment group(P<0.05).Moreover the scores of nursing satisfaction degree in experimental group were significantly higher than those in routine treatment group(P<0.05),however,the length of staying in hospital in experimental group were significantly shorter than that in routine treatment group(P<0.05).Conclusion The cluster nursing intervention for patients with COPD can effectively prevent and control multi-drug resistant bacterial infection,improve the effects of nursing measures implemented by medical staff and improve patients' satisfaction degree,moreover,which can shorten the treatment duration.
引文
1 吕青兰.慢性心力衰竭合并慢性阻塞性肺疾病老年患者预后影响因素.中国老年学杂志,2013,33:3338-3339.
2 赵娜,崔文香.集束化护理措施预防呼吸机相关性肺炎效果评价的Meta分析.中国实用护理杂志,2014,30:20-24.
3 范晓华,曹岳蓉,徐娟.呼吸机相关性肺炎集束化护理方案预防的效果研究.中华医院感染学杂志,2015,25:4203-4205.
4 余伟鹏,冼美兰.慢性阻塞性肺疾病并发呼吸机相关性肺炎的痰培养菌种分布和细菌耐药分析.中国感染与化疗杂志,2015,15:538-541.
5 应少聪,周向东,刘益琼,等.康复训练结合健康教育对老年慢性阻塞性肺疾病患者生活质量及其心理健康状况的影响.中华物理医学与康复杂志,2014,36:333-336.
6 Janssen DJ,Spruit MA,Schols JM,et al.Dynamic Preferences for Site of Death Among Patients With Advanced Chronic Obstructive Pulmonary Disease,Chronic Heart Failure,or Chronic Renal Failure.Journal of Pain and Symptom Management,2013,46:826-836.
7 Hiramatsu T,Sugiyama M,Kuwabara S,et al.Effectiveness of an outpatient preoperative care bundle in preventing postoperative pneumonia among esophageal cancer patients.Am J Infect Control,2014,42:385-388.
8 Allen A,Collins CD,Anjly K,et al.Impact of an antimicrobial stewardship program comprehensive care bundle on management of candidemia.Pharma J Human Pharma Drug Therapy,2013,33:137-143.
9 李梅玲,黄洁,赵昱瑾,等.重症监护病房多重耐药菌交叉感染降阶梯防控策略的临床应用研究.中国感染与化疗杂志,2015,15:552.
10 陈倩,谢清华,陈建萍,等.集束化干预控制MRSA感染与定植的效果观察.中国微生态学杂志,2015,27:950.
11 Feldman GJ.Improving the quality of life in patients with chronic obstructive pulmonary disease:focus on indacaterol.Interna J Copd,2013,8:89-96.
2 赵娜,崔文香.集束化护理措施预防呼吸机相关性肺炎效果评价的Meta分析.中国实用护理杂志,2014,30:20-24.
3 范晓华,曹岳蓉,徐娟.呼吸机相关性肺炎集束化护理方案预防的效果研究.中华医院感染学杂志,2015,25:4203-4205.
4 余伟鹏,冼美兰.慢性阻塞性肺疾病并发呼吸机相关性肺炎的痰培养菌种分布和细菌耐药分析.中国感染与化疗杂志,2015,15:538-541.
5 应少聪,周向东,刘益琼,等.康复训练结合健康教育对老年慢性阻塞性肺疾病患者生活质量及其心理健康状况的影响.中华物理医学与康复杂志,2014,36:333-336.
6 Janssen DJ,Spruit MA,Schols JM,et al.Dynamic Preferences for Site of Death Among Patients With Advanced Chronic Obstructive Pulmonary Disease,Chronic Heart Failure,or Chronic Renal Failure.Journal of Pain and Symptom Management,2013,46:826-836.
7 Hiramatsu T,Sugiyama M,Kuwabara S,et al.Effectiveness of an outpatient preoperative care bundle in preventing postoperative pneumonia among esophageal cancer patients.Am J Infect Control,2014,42:385-388.
8 Allen A,Collins CD,Anjly K,et al.Impact of an antimicrobial stewardship program comprehensive care bundle on management of candidemia.Pharma J Human Pharma Drug Therapy,2013,33:137-143.
9 李梅玲,黄洁,赵昱瑾,等.重症监护病房多重耐药菌交叉感染降阶梯防控策略的临床应用研究.中国感染与化疗杂志,2015,15:552.
10 陈倩,谢清华,陈建萍,等.集束化干预控制MRSA感染与定植的效果观察.中国微生态学杂志,2015,27:950.
11 Feldman GJ.Improving the quality of life in patients with chronic obstructive pulmonary disease:focus on indacaterol.Interna J Copd,2013,8:89-96.