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題 名 | 北部某醫學中心外科加護病房呼吸器相關肺炎組合式照護推動經驗=Use of VAP Bundle to Prevent Ventilator- Associated Pneumonia in a Medical Center Surgical Intensive Care Unit |
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作 者 | 謝怡然; 張藏能; 施玉珊; 哈多吉; 李淑華; | 書刊名 | 感染控制雜誌 |
卷 期 | 24:3 2014.06[民103.06] |
頁 次 | 頁122-132 |
分類號 | 415.463 |
關鍵詞 | 呼吸器相關肺炎; 組合式照護; 加護病房; Ventilator-associated pneumonia; VAP bundle; Intensive care units; |
語 文 | 中文(Chinese) |
英文摘要 | Although preventable, ventilator-associated pneumonia (VAP) is a main cause of death due to nosocomial infections in the intensive care unit (ICU). This study was conducted in the surgical ICU of a medical center in Taipei, Taiwan, from March 2011 to December 2012. A multidisciplinary ventilator bundle team was established during the study period. The bundle checklist included daily “sedation vacation” and assessment of readiness to extubate, peptic ulcer prophylaxis, oral hygiene care every 4 h, suction of oral secretions before changing position, as well as maintaining a 30-45° head elevation and endotracheal tube cuff pressure. The results showed a daily goal checklist implementation rate increase from 50% to 74%. The ventilator bundle compliance rate, assessed by external audit, increased from 79% to 93%. During the study period, the checklist execution rate declined to <50% between July and August 2012, although education, training, and regular feedback from external auditing units can encourage the clinical care team to improve implementation rates. Checklist implementation rate had declined to <50% between July and August 2012. Nevertheless, staff education and regular feedback from external audit data can improve implementation rates. In addition, longer respiratory tubing and thick red tape marks improved the compliance rate of maintaining a head-up position to 95%. Twenty-two months after implementation, VAP incidence decreased from 5.1 to 2.8 per 1,000 ventilator days (P = 0.01). Our results show that implementation of ventilator bundles can reduce VAP incidence. |
本系統中英文摘要資訊取自各篇刊載內容。