CAJ | 학술논문

目的探讨能够提高护士对使用呼吸机患者抬高床头30～45°的依从性的策略，并评价临床效果。方法2012年1-7月“解决问题，促进健康”方法实施前在某院ICU行有创机械通气的78例患者为对照组，2012年10月-2013年5月“解决问题，促进健康”方法实施后在某院ICU行有创机械通气的119例患者为观察组，采用护士培训、改善工作条件、张贴宣传画等措施，评价两组护士对床头抬高的依从性，呼吸机相关性肺炎（ VAP）的发生率。结果观察组18名护士对使用呼吸机患者床头抬高30～45°的依从性为55．2％，高于对照组的22．0％，差异有统计学意义（χ2＝237．4，P＜0．01）；观察组VAP&nbsp；的发病率为10．1‰，明显低于对照组的26．8‰，差异有统计学意义（χ2＝5．11，P＜0．05）。结论干预后护士对使用呼吸机患者床头抬高的依从性增高，VAP发病率降低，对促进患者健康有重要的意义。
목적탐토능구제고호사대사용호흡궤환자태고상두30～45°적의종성적책략，병평개림상효과。방법2012년1-7월“해결문제，촉진건강”방법실시전재모원ICU행유창궤계통기적78례환자위대조조，2012년10월-2013년5월“해결문제，촉진건강”방법실시후재모원ICU행유창궤계통기적119례환자위관찰조，채용호사배훈、개선공작조건、장첩선전화등조시，평개량조호사대상두태고적의종성，호흡궤상관성폐염（ VAP）적발생솔。결과관찰조18명호사대사용호흡궤환자상두태고30～45°적의종성위55．2％，고우대조조적22．0％，차이유통계학의의（χ2＝237．4，P＜0．01）；관찰조VAP&nbsp；적발병솔위10．1‰，명현저우대조조적26．8‰，차이유통계학의의（χ2＝5．11，P＜0．05）。결론간예후호사대사용호흡궤환자상두태고적의종성증고，VAP발병솔강저，대촉진환자건강유중요적의의。
Objective To explore the strategies that can improve the nurses ’ compliance of raising the head of a bed for 30 -45 °on mechanical ventilation patients and evaluate the clinical effect .Methods Before implementing “problem solving for better health ( PSBH )”, 78 patients of invasive mechanical ventilation in ICU were included as the control group from January 2012 to July 2012 .After implementing PSBH , 119 patients were included as the experimental group , from October 2012 to May 2013 .By training the nurses , improving the working conditions and putting up posters , the compliance of nurses and the incidence of ventilator associated pneumonia from each group were compared .Results Nurses’ compliance of raising the head of bed for 30-45°was 55.2%in experimental group, which was higher than that of control group (22.0%).The difference was statistically significant (χ2 =237.4, P <0.01).The incidence of ventilator associated pneumonia was 10.1‰ in experimental group, which was lower than that of control group (26.8‰).The difference was statistically significant (χ2 =5.11, P <0.05).Conclusions After the PSBH intervention, the nurses’ compliance of raising the head of bed was increased , and the incidence of ventilator associated pneumonia was reduced.PSBH plays an important role in promoting the patients ’ health.