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題名 | 院內感染控制--「呼吸器相關肺炎」之預防=Prevention of Ventilator Association Pneumonia |
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作 者 | 廖玉美; 蘇理盈; 周汎澔; | 書刊名 | 中華民國重症醫學雜誌 |
卷期 | 8:2 民95 |
頁次 | 頁77-84 |
分類號 | 419.38 |
關鍵詞 | 院內感染控制; 呼吸器相關肺炎; Nosocomia infection control; Ventilator associated pneumonia; |
語文 | 中文(Chinese) |
中文摘要 | 病人安全是健康照護體系當前一個重要的議題,創造安全的環境是所有醫療人員所必須參與病人照護的共同議題,其中最值得關注的就是呼吸道感染性肺炎。根據國内在1999-2002年院内感染統計顯示呼吸道感染率佔14-20%。據統計住院病人中約有千分之5~10會發生呼吸器相關肺炎,導致醫療花費增加、使用呼吸器的時間延長、住院天數及死亡率增加。重症病患中使用呼吸器者有10%至25%會罹患此病。近年來已証實呼吸器相關肺炎疾病傳播需要同時有感染源、易感宿主及傳染途徑三要素之感染鍊形成,其控制方法是針對感染發生的原因可利用各種感染管制措施來中斷感染鏈的形成。 綜合實証文獻的結果,發現非藥物性的預防方法包括一般性預防插管、呼吸器的照護、口腔護理及姿位和管灌飲食的照護等,為預防呼吸器相關肺炎的重要措施。期望藉由此呼吸器相關肺炎的文獻探討,使臨床護理人員更能了解其疾病變化、診斷方式及相關之預防護理措施,提升照護知識及技能,讓整體的重症照護品質能提昇,並且提供病患更好的護理照護品質以預防呼吸器相關肺炎感染率之成效。 |
英文摘要 | The patient safety is an important issue in the contemporary health care system. Thus, the common interest for all health-care providers is creating a safe environment for all patients (JCAHO, 2005). Among the problems, which may jeopardize the patient safety, the respiratory tract infection is one of the emerging issue which worth paying attention to. In 1999-2002, a domestic epidemiology study of nosocomial respiratory tract infection incidence is about 14~20% (Cheng et. Al., 2004). The incidence of patient who are mechanical ventilated and contracted with ventilator associated pneumonia (VAP) is about 5~10%. Consequently, it prolonged the time of ventilator use, increasing the length of stay and result in the raise of medical expense. Fatally it also raises the mortality rate (Keith, Gurrett, Hickoxand Comeau, 2004). In addition, the incidence of VAP in the critical illness is about 10~25% (Craven and Steger, 1996). In the last decade increasing evident shown that there are three components on the chain to cause the ventilator associated pneumonia (VAP), they are infectious agent, susceptible host and infection route. The strategy to prevent VAP is depending on blockade of the VAP components to break the chain. The recent literatures confirm the effective prophylactic nonpharmacological methods are early intubation and mechanical ventilation, oral hygiene dare, semicumbent positioning and enteral feeding care. This review would discuss the pathophysiology, diagnosis method and nursing strategy for the VAP critical ill patients. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。