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find Keyword "重症监护病房" 61 results
  • Monitoring and Analysis of Ventilator-associated Pneumonia in Intensive Care Unit

    目的 了解综合重症监护病房(ICU)呼吸机相关性肺炎(VAP)感染率、危险因素、病原菌分布及其耐药情况,探讨有针对性的预防控制措施。 方法 2009年1月-12月综合ICU共收治患者447例,采用主动监测方法,由ICU医务人员和专职人员每日对综合ICU病房住院时间≥48 h且撤停机械通气后48 h内的患者进行VAP监测。 结果 447例患者中住院时间≥48 h的患者168例,96例患者使用呼吸机,使用呼吸机时间182 d,ICU住院总日数1 339 d,发生VAP 17例,呼吸机使用率13.59%,VAP感染率93.4例/1 000机械通气日,根据平均病情严重程度(ASIS法)调整后的VAP感染率为2.38%。呼吸机使用方式与VAP发生有关联。检出病原菌18株,全部为Gˉ杆菌,其中鲍曼不动杆菌4株,对包括硫霉素、氨曲南在内的多种抗菌药物耐药。 结论 综合ICU病房VAP感染率为2.38%,呼吸机使用不当是VAP的危险因素,VAP致病菌为Gˉ杆菌,其中鲍曼不动杆菌耐药率达100%,并呈多重耐药性;抗生素使用时间过长,预防性使用不当是致病菌产生多重耐药的重要原因。

    Release date:2016-09-08 09:18 Export PDF Favorites Scan
  • Effect of Bundle Interventions on Ventilator-associated Pneumonia in Intensive Care Unit

    ObjectiveTo observe the effect of bundle interventions on ventilator-associated pneumonia (VAP) in Intensive Care Unit (ICU). MethodsBaseline survey among the patients undergoing mechanical ventilation was conducted during June 2011 to August 2011. During September 2011 to May 2012, the rate of VAP was monitored every three months after taking bundle measures, which included oral care, elevation of the head of the bed, daily assessment of readiness to extubation, optimizing process of devices disinfection and hand hygiene. ResultsThrough carrying out the bundle interventions, the VAP rate decreased from 61.2‰ to 34.9‰ after six months and 22.7‰ after nine months, and the ventilator utilization ratio decreased from 26.5% to 24.6% after six months and 22.6% after nine months. The alcohol-based hand disinfectant dosage was increased from 32.6 mL to 58.8 mL and 54.4 mL for each patient bed in ICU. ConclusionThe bundle intervention has been proved to be effective. Measures such as staff education, bedside supervision and monitoring data feedback can help implement bundle interventions.

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  • Effect of “net bottom” management in the prevention and control of device-associated infections in elderly patients in emergency intensive care unit

    Objective To explore the effect of “net bottom” management in the control of device-associated infections (DAIs) in elderly patients by setting infection monitoring doctors and nurses in the emergency intensive care unit (EICU). Methods Elderly patients who aged≥60 years old admitted to the EICU of the First People’s Hospital of Lianyungang between April 2018 and March 2021 were selected as the research subjects. A “net bottom” management mode was established and implemented for the purpose of infection prevention and control, taking medical and other departments as the coordination and management subjects, and infection monitoring doctors and nurses as the core. The effectiveness of the management intervention was evaluated by comparing the incidences of DAIs in elderly patients, the compliance rates of medical staff in hand hygiene, and the consumption of hand sanitizer per bed day in EICU among the primary stage (from April 2018 to March 2019), intermediate stage (from April 2019 to March 2020), and later stage (from April 2020 to March 2021). Results During the primary stage, intermediate stage, and later stage, there were 540, 497, and 507 elderly inpatients in EICU monitored, respectively, and the incidences of nosocomial infections were 7.22% (39/540), 5.84% (29/497), and 4.14% (21/507), respectively, showing a decreasing trend (χ2trend=4.557, P=0.033). The incidences of ventilator-associated pneumonia, central line-associated bloodstream infections, and catheter-associated urinary tract infections decreased from 4.82‰, 2.53‰, and 0.95‰, respectively in the primary stage, to 0.51‰, 1.01‰, and 0.53‰, respectively in the later stage, among which the difference in the incidence of ventilator-associated pneumonia was statistically significant (P<0.05). The hand hygiene compliance rate of EICU medical staff increased from 70.39% to 86.67% (P<0.05), and the consumption of hand sanitizer per bed day increased from 33.70 mL to 67.27 mL. The quarterly hand hygiene compliance rate was positively correlated with the quarterly consumption of hand sanitizer per bed day (rs=0.846, P=0.001), and negatively correlated with the quarterly incidence of nosocomial infections (rs=–0.769, P=0.003). Conclusion The “net bottom” management by setting up infection monitoring doctors and nurses in the EICU and multi-department collaboration can reduce the incidence of DAIs in elderly patients in EICU, which plays a positive role in promoting the hospital infection management and improving the quality of hospital infection management.

    Release date:2022-04-25 03:47 Export PDF Favorites Scan
  • Effect of quality control circle in reducing ventilator-associated pneumonia in Pediatric Intensive Care Unit

    Objective To investigate the effect of quality control circle in reducing ventilator-associated pneumonia in Pediatric Intensive Care Unit (PICU). Methods A total of 1 249 child patients who underwent mechanical ventilation between January and December 2013 were chosen as the control group, and they accepted routine management. Another 1 208 child patients treated between January and December 2014 were selected as the observation group, and quality control circle was adopted. The compliance of ventilator care bundles, the duration of mechanical ventilation, the length of PICU stay and the incidence of ventilator-associated pneumonia were compared between the two groups. Results Compared with the control group, compliance of ventilator care bundles was higher in the observation group (P<0.01), the duration of mechanical ventilation was shorter [(6.9±2.4) daysvs. (4.6±2.2) days], the length of PICU stay was shorter [(9.2±3.1) daysvs. (7.7±2.4) days], and the incidence of ventilator-associated pneumonia was lower (22.4‰vs. 9.1‰) (P<0.05). Conclusion Application of quality control circle can significantly promote the compliance of ventilator care bundles, and decrease the duration of mechanical ventilation, the length of PICU stay and the incidence of ventilator-associated pneumonia.

    Release date:2017-01-18 08:50 Export PDF Favorites Scan
  • Homogeneous Analysis of Multidrug Resistant Acinetobacter baumannii in Emergency Intensive Care Unit

    Objective To investigate the drug resistance and homogeneous analysis of Acinetobacter baumanii in emergency intensive care unit ( EICU) . Methods Four multidrug-resistant Acinetobacter baumannii ( MDR-Ab) strains isolated fromnosocomial inpatients fromJuly 25 to September 7 in 2009 were collected and tested for drug sensitivity and MIC determination as well. The A. baumannii isolates were typed with pulsed-field gel electrophoresis ( PFGE) to determine whether they derived fromthe same clone.Results Four isolates from nosocomial inpatients were resistant to multiple antibiotics including carbapenem. The PFGE types identified from four isolates were A and B. The A. baumannii isolates did not derived from the same clone. Conclusion The prevalence of nosocomial infection is not due to transmission of the same strains among different individuals in EICU.

    Release date:2016-08-30 11:56 Export PDF Favorites Scan
  • 巴林特小组在重症监护病房护理工作中的应用

    目的 探讨巴林特小组在重症监护病房护理中的应用效果。 方法 2015 年 6 月在心理卫生中心协助下成立巴林特小组,按流程开展活动,报告人汇报案例,组长与成员协助分析梳理,采用倾听、提问、回答等方式,最后进行总结。对 1 例典型病例进行详细分析。 结果 在典型案例中,汇报人在巴林特小组组长与成员的引导下主动表述其感受,能换位思考患者情况,不良情绪得到逐渐缓解,认识得到提高,并在之后的护患沟通中体现良好的持续影响,取得了患者的信任与理解。 结论 通过巴林特小组的活动,能搭建相互支持、交流、学习的平台,提高护士自我觉察、倾听、观察和沟通能力,促进护士个人成长,改善职业倦怠,和谐护患关系。

    Release date:2017-04-19 10:17 Export PDF Favorites Scan
  • The Psychological States and Their Influencing Factors in the Parents of Congenital Defect Neonates Admitted to Intensive Care Unit

    ObjectiveTo investigate the psychological states and their influencing factors in parents of congenital defect neonates admitted to Intensive Care Unit (ICU). MethodsThe self-designed general information questionnaire was used to collect the demographic data, and self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to evaluate the states of anxiety and depression of the parents of congenital defect neonates admitted to ICU between June 1 and November 29, 2013. ResultsA total of 152 parents were included in this investigation. The average score of SAS was 39.45±8.53. The average score of SDS was 43.28±10.76. Univariate analysis found that parents with lower educational level, poorer family income, positive family history and countryside residence might have higher score of SAS, while parents with Han nationality, poorer family income and family history would have higher score of SDS. Multivariate analysis discovered that living condition and family history were related to anxiety status. However, depression state was influenced by nationality, family income and family history. ConclusionA considerable number of parents of congenital defect neonates admitted to ICU have anxiety or depression. And nationality, family income, family history and living condition are the major risk factors.

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  • 重症医学科构建外周静脉置入中心静脉导管医护一体的工作模式探讨

    目的在重症医学科(ICU)开展外周静脉置入中心静脉导管(PICC)医护一体合作的工作模式,以提高PICC置管的成功率,解决重症患者置管的相关问题,降低导管相关性血流感染(CRBSI)发生率。 方法选择2010年4月-2012年3月入住ICU的置入PICC的患者229例,按照入住日期单双数分为对照组和试验组,比较两组CRBSI的发生率和PICC置管成功率。 结果试验组CRBSI发生率明显低于对照组;且试验组的PICC置管成功率明显高于对照组,差异均有统计学意义(P<0.01)。 结论ICU构建PICC医护一体的工作模式,能显著提高重症患者PICC置管成功率和安全性,降低CRBSI发生率,减少了重症患者反复静脉穿刺的痛苦,保护患者外周静脉,提高护理质量及工作效率。

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  • 多功能肠内营养泵用于重症监护病房危重患者鼻饲的临床效果观察

    目的探讨多功能肠内营养泵对鼻饲管堵管率以及冲洗鼻饲管护理时间的影响。 方法将2013年7月-12月收治的危重症并行肠内营养患者100例按入重症监护病房的先后顺序依次分入试验组和对照组,对照组选取普通输液泵鼻饲,试验组选取多功能肠内营养泵鼻饲,比较两组患者鼻饲管堵管率、鼻饲管冲洗花费的护理时间。 结果试验组与对照组分别发生鼻饲管堵管2例(4%)和14例(28%),两组比较差异有统计学意义(χ2=10.714,P=0.001);试验组冲洗鼻饲管无需占用护理人员时间,而对照组则需花费(20.78±1.88)s。 结论多功能肠内营养泵能降低鼻饲管堵管率,可减少冲洗鼻饲管的护理时间。

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  • Effects of Active Intervention in Prevention and Control of Nosocomial Infection in ICU: A Non-concurrent Control Trial

    Objective To evaluate the effect of active screening and intervention of multidrug-resistant organisms (MDROs) on control nosocomial infection in the general intensive care unit (ICU). Methods A non-concurrent control trial was conducted in patients hospitalized in the ICU for more than 24 hours in the Second Affiliated Hospital of Fujian Medical University. Patients underwent active screening of MDROs for nasal vestibular swab, throat swab and rectal swab combined with further intensive intervention for patients with positive screening result during Sept. 2014 to Aug. 2015 were included as an intervention group, patients only underwent active screening during Sept. 2013 to Aug. 2014 were included as a screening group, and patients without undergoing active screening during Sept. 2012 to Aug. 2013 were as a control group. SPSS 19.0 software was used to compare the hospital infection rate and the infection rate of MDROs among the three groups. Results A total of 1 773 patients were included, of which 655 patients were in the intervention group, 515 patients were in the screening group, and 603 patients were in the control group. The difference of hospital infection rates among the three groups was statistically significant (χ2=21.087, P < 0.001), and further pairwise comparison results showed that the intervention group was lower than the screening group (χ2=5.891, P=0.015), and the screening group was lower than the control group (χ2=4.259, P=0.039). The adjustment daily infection rate of the intervention group, screening group and control group were 6.69‰, 10.88‰, and 15.39‰, respectively. The difference of MDROs hospital infection rates among the three groups was statistically significant (χ2=21.039, P < 0.001), and further pairwise comparison results showed that the intervention group was lower than the screening group (χ2=5.936, P=0.015), and the screening group was lower than the control group (χ2=5.798, P=0.016). The MDROs thousand daily infection rate of the intervention group was lower than that of the screening group (3.90‰ vs. 7.30‰, χ2=5.999, P=0.014). Conclusion The active screening plus intensive intervention of MDROs can effectively reduce the incidence rates of nosocomial infections and MDROs infections in ICU.

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