To Explore The Related Factors of Ventilator-Assocoated Pneumonia in Critical Care Patients under Ventilator Bundle Care

• Main Authors: Ssu-chin Lin, 林思親
• Other Authors: Yi-Maun Subeq
• Format: Others
• Language: zh-TW
• Published: 2014
• Online Access: http://ndltd.ncl.edu.tw/handle/81650289501975727156

碩士 === 慈濟大學 === 護理學系碩士班 === 102 === Pneumonia is one of the most common nosocomial infections occurring in critical patients. Patients received ventilatory support account for 86% of the cases of nosocomial pneumonia. Ventilator associated pneumonia will not only increase patients’ mortality rate but also accrue the consumption of medical resources. The purpose of this study was to to explore the related factors of ventilator-assocoated pneumonia in critical care patients under ventilator bundle care. This is an observational Study with purposive sampling in medical intensive care units of a regional hospital in eastern Taiwan. The study period was lasted from July, 2013 to December, 2013. The samplings include 30 critical patient requiring mechanical ventilation and > 20 years old to participate in the study. Informed consent was obtained from the patient or, if this was not possible, from a representative of the family. Patients with subglottic endotracheal tube implement subglottic secretion drainage, Patients with traditional endotracheal tube use oral secretion drainage. They all received routine ventilator bundle care; include hand hygiene, endotracheal suction, oral hygiene with 2% chrohexidine lotion, head up about 30 – 45 degree, interruption of sedative in seven o’clock, and maintaining cuff pressure 20-25mH2O. The incidence of VAP was defined by the CDC criteria of diagnosis nosocomial pneumonia. The results showed that: 1. Male, history of chronic obstructive pulmonary disease and diagnose of septic shock case did not increase ventilator associated pneumonia infection. 2 Case who use antibiotics, antacids and medication nebulizers did not increase the infection rate of ventilator-associated pneumonia. 3. The infection rate of ventilator-associated pneumonia was no significance in case who received subglottic secretion drainage or oral secretion drainage (P> .05). 4. There were no significant differences (P> .05) in ventilator days and ICU days with case who using subglottic secretion drainage or oral secretions drainage. Conclusion is: the implementation of ventilator bundle care can achieve an effective reduction effect of ventilator-associated pneumonia, and therefore subglottic secretion drainage did not prevent ventilator-associated pneumonia effectively. The results also provide first-line clinical staff and hospital manager for the prevention of ventilator-associated pneumonia care.