集束化护理管理在艾滋病合并肺结核病人纤维支气管镜诊疗感染控制中的应用
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摘要
[目的]探讨集束化护理管理在艾滋病合并肺结核病人纤维支气管镜诊疗感染控制中的应用效果。[方法]选取2016年8月—2017年7月行纤维支气管镜诊疗的病人108例为对照组,2017年8月—2018年7月行纤维支气管镜诊疗的病人113例为观察组。对照组实施常规护理管理,观察组在常规护理管理的基础上实施感染控制临床护理路径、个性化心理干预、加强督导检查、加强学习培训考核、加强宣传教育等集束化护理管理。比较两组环境学监测指标合格率、操作时间、医院感染发生率。[结果]观察组环境学监测指标合格率高于对照组,操作时间[(6.01±1.52)min]短于对照组[(9.65±2.32)min],医院感染发生率(0.35%)低于对照组(6.48%),差异均有统计学意义(P<0.05)。[结论]在艾滋病合并肺结核病人纤维支气管镜诊疗常规护理上应用集束化护理管理能提高环境学监测指标合格率,缩短操作时间,降低医院感染发生率。
Objective:To investigate the effect of cluster nursing management on infection control of bronchoscopy in patients with AIDS complicated with pulmonary tuberculosis.Methods:A total of 108 patients who underwent fiberoptic bronchoscopy from August 2016 to July 2017 were selected as the control group.From August 2017 to July 2018,113 patients who underwent fiberoptic bronchoscopy were included in the observation group.The control group implemented routine nursing management.The observation group implemented the infection nursing clinical nursing path,personalized psychological intervention,strengthening supervision and inspection,strengthening study and training assessment,strengthening publicity and education and other grouped nursing management on the basis of routine nursing management.The eligibility rate of environmental monitoring indicators,operation time and incidence of nosocomial infection were compared between the two groups.Results:The qualified rate of environmental monitoring indicators in the observation group was higher than that in the control group.The operation time of the observation group[(6.01±1.52)min] was shorter than that of the control group[(9.65±2.32)min].The incidence of nosocomial infection(0.35%) was lower than that of the control group(6.48%),and these differences were all statistically significant(P<0.05).Conclusion:The application of cluster nursing management in the diagnosis and treatment of AIDS concomitant tuberculosis patients with bronchoscopy could improve the qualified rate of environmental monitoring indicators,shorten the operation time and reduce the incidence of nosocomial infection.
Objective:To investigate the effect of cluster nursing management on infection control of bronchoscopy in patients with AIDS complicated with pulmonary tuberculosis.Methods:A total of 108 patients who underwent fiberoptic bronchoscopy from August 2016 to July 2017 were selected as the control group.From August 2017 to July 2018,113 patients who underwent fiberoptic bronchoscopy were included in the observation group.The control group implemented routine nursing management.The observation group implemented the infection nursing clinical nursing path,personalized psychological intervention,strengthening supervision and inspection,strengthening study and training assessment,strengthening publicity and education and other grouped nursing management on the basis of routine nursing management.The eligibility rate of environmental monitoring indicators,operation time and incidence of nosocomial infection were compared between the two groups.Results:The qualified rate of environmental monitoring indicators in the observation group was higher than that in the control group.The operation time of the observation group[(6.01±1.52)min] was shorter than that of the control group[(9.65±2.32)min].The incidence of nosocomial infection(0.35%) was lower than that of the control group(6.48%),and these differences were all statistically significant(P<0.05).Conclusion:The application of cluster nursing management in the diagnosis and treatment of AIDS concomitant tuberculosis patients with bronchoscopy could improve the qualified rate of environmental monitoring indicators,shorten the operation time and reduce the incidence of nosocomial infection.
引文
[1] 美国疾病预防控制中心.HIV感染者机会性感染防治指南[M].北京:北京大学医学出版社,2011:22-27.
[2] 张孟璋,李庶甘,李茵,等.单纯肺结核病与HIV/AIDS合并肺结核的临床特征观察[J].中国现代医生,2017,55(26):86-88.
[3] 陈丽莎,李红,陈锦文.肺结核患者医院感染的影响因素与防范对策[J].中医药管理杂志,2018,26(4):95-97.
[4] 侯妹冬,梁月新.临床护理路径在AIDS患者/HIV感染者纤维支气管镜诊疗中的应用[J].护理学报,2013,20(8B):13-15.
[5] 王成林.痰标本在细菌学检验中的应用[J].现代医药卫生,2013,29(23):3612-3613.
[6] TAYYIB N,COYER F.Translating pressure ulcer prevention into intensive care nursing practice:overlaying a care bundle approach with a model for research implementation[J].J Nurs Care Qual,2017,32(1):6-14.
[7] 中华医学会感染病学分会艾滋病学组.艾滋病诊疗指南[J].中华临床感染病杂志,2015,8(5):385-401.
[8] 葛均波,徐永健.内科学[M].8版.北京:人民卫生出版社,2013:61-74.
[9] 石凤红.细节管理在口腔科门诊医院感染控制中的应用效果[J].护理研究,2017,31(9):1149-1150.
[10] 李旺,徐六妹,陈敬芳.188例HIV/AIDS 患者支气管镜检查的护理体会[J].护理学报,2017,24(3):57-59.
[11] 刘运喜,邢玉斌,索继江,等.《软式内镜清洗消毒技术规范》解读与释义[J].中华医院感染学杂志,2017,27(16):3612-3615.
[12] 张秀,刘丽英,吴丹,等.HIV感染者/AIDS患者心理状态及护理干预研究进展[J].中国护理管理,2013,13(11):84-86.
[13] 胡国庆,段亚波.GB15982-2012《医院消毒卫生标准》内容解读(一)[J].中国消毒学杂志,2013,30(7):649-652.
[14] 黄琴,关建萍,李晓春,等.240例HIV/AIDS患者自我管理能力现状及影响因素分析[J].护理学报,2017,24(22):46-49.
[15] 孙文秀,卢洪洲,张林,等.同伴支持在HIV阳性患者中运用的研究进展[J].中华护理杂志,2018,53(2):238-241.
[16] SANGARAMOORTHY T,JAMISON A M,DYER T V.HIV stigma,retention in care,and adherence among older Black women living with HIV[J].J Assoc Nurses AIDS Care,2017,28(4):518-531.
[17] MAK W W S,MO P K H,MA G Y K,et al.Meta-analysis and systematic review of studies on the effectiveness of HIV stigma reduction programs[J].Soc Sci Med,2017,188:30-40.
[18] PRINSLOO C D,GREEFF M,KRUGER A,et al.HIV stigma experiences and stigmatisation before and after a HIV stigma-reduction community “hub” intervention[J].Afr J AIDS Res,2017,16(3):203-213.
[19] 司海龙,别文倩,张嘉萌,等.大学生艾滋病同伴教育的研究进展[J].循证护理,2017,3(5):464-468.
[20] 董晓庆,季建强,王燕,等.2012年南京市艾滋病筛查实验室质量考评结果分析[J].中国医学创新,2013,10(29):99-100.
[2] 张孟璋,李庶甘,李茵,等.单纯肺结核病与HIV/AIDS合并肺结核的临床特征观察[J].中国现代医生,2017,55(26):86-88.
[3] 陈丽莎,李红,陈锦文.肺结核患者医院感染的影响因素与防范对策[J].中医药管理杂志,2018,26(4):95-97.
[4] 侯妹冬,梁月新.临床护理路径在AIDS患者/HIV感染者纤维支气管镜诊疗中的应用[J].护理学报,2013,20(8B):13-15.
[5] 王成林.痰标本在细菌学检验中的应用[J].现代医药卫生,2013,29(23):3612-3613.
[6] TAYYIB N,COYER F.Translating pressure ulcer prevention into intensive care nursing practice:overlaying a care bundle approach with a model for research implementation[J].J Nurs Care Qual,2017,32(1):6-14.
[7] 中华医学会感染病学分会艾滋病学组.艾滋病诊疗指南[J].中华临床感染病杂志,2015,8(5):385-401.
[8] 葛均波,徐永健.内科学[M].8版.北京:人民卫生出版社,2013:61-74.
[9] 石凤红.细节管理在口腔科门诊医院感染控制中的应用效果[J].护理研究,2017,31(9):1149-1150.
[10] 李旺,徐六妹,陈敬芳.188例HIV/AIDS 患者支气管镜检查的护理体会[J].护理学报,2017,24(3):57-59.
[11] 刘运喜,邢玉斌,索继江,等.《软式内镜清洗消毒技术规范》解读与释义[J].中华医院感染学杂志,2017,27(16):3612-3615.
[12] 张秀,刘丽英,吴丹,等.HIV感染者/AIDS患者心理状态及护理干预研究进展[J].中国护理管理,2013,13(11):84-86.
[13] 胡国庆,段亚波.GB15982-2012《医院消毒卫生标准》内容解读(一)[J].中国消毒学杂志,2013,30(7):649-652.
[14] 黄琴,关建萍,李晓春,等.240例HIV/AIDS患者自我管理能力现状及影响因素分析[J].护理学报,2017,24(22):46-49.
[15] 孙文秀,卢洪洲,张林,等.同伴支持在HIV阳性患者中运用的研究进展[J].中华护理杂志,2018,53(2):238-241.
[16] SANGARAMOORTHY T,JAMISON A M,DYER T V.HIV stigma,retention in care,and adherence among older Black women living with HIV[J].J Assoc Nurses AIDS Care,2017,28(4):518-531.
[17] MAK W W S,MO P K H,MA G Y K,et al.Meta-analysis and systematic review of studies on the effectiveness of HIV stigma reduction programs[J].Soc Sci Med,2017,188:30-40.
[18] PRINSLOO C D,GREEFF M,KRUGER A,et al.HIV stigma experiences and stigmatisation before and after a HIV stigma-reduction community “hub” intervention[J].Afr J AIDS Res,2017,16(3):203-213.
[19] 司海龙,别文倩,张嘉萌,等.大学生艾滋病同伴教育的研究进展[J].循证护理,2017,3(5):464-468.
[20] 董晓庆,季建强,王燕,等.2012年南京市艾滋病筛查实验室质量考评结果分析[J].中国医学创新,2013,10(29):99-100.