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目的观察集束干预措施对于重症监护病房(ICU)呼吸机相关肺炎(VAP)发病率的影响。方法选取2011年6月-8月ICU使用呼吸机的患者作为基线调查对象,2011年9月-2012年5月实施集束干预措施后每3个月评估1次VAP发病率。结果呼吸机使用率由干预前的26.5%降至干预实施6个月后的24.6%和9个月后的22.6%,VAP发病率由61.2‰降至34.9‰、22.7‰,速干手消毒剂的用量由每床日32.6 mL增至58.8、54.4 mL。结论集束干预措施对于预防VAP效果明显,人员培训、床旁督导及监测反馈能有效促进干预措施执行。
Objective To observe the effect of cluster intervention on the incidence of ventilator associated pneumonia (VAP) in intensive care unit (ICU). Methods Patients in the ICU using ventilator between June and August 2011 were selected as the baseline subjects. The incidence of VAP was assessed every 3 months after the implementation of cluster interventions from September 2011 to May 2012. Results The rate of ventilator use decreased from 26.5% before intervention to 24.6% at 6 months after intervention and 22.6% after 9 months. The incidence of VAP decreased from 61.2% to 34.9% and 22.7% Dosage increased from 32.6 mL per bed to 58.8,54.4 mL. Conclusions The cluster interventions are effective in preventing VAP. Staff training, bedside supervision and monitoring feedback can effectively promote the implementation of interventions.