以科室为单位强化ICU护士呼吸机相关性肺炎循证护理培训

目的开展ICU预防呼吸机相关性肺炎(VAP)循证护理培训教育并评价其成效。方法以2008年美国重症护理协会预防VAP循证护理实践指南为培训教材,并以此为导向设置课程,对17名ICU护士进行培训,采用预防VAP护理质量标准评价量表评价培训前后护士的认知和行为变化。结果护士培训后质量评价总体水平较培训前明显改善,差异有统计学意义(Z=-3.624,P=0.000)。质量评价的7个维度中,除洗手外,卧位护理、气道护理、肠内营养护理、气囊套管护理、口腔护理、呼吸机管道护理6个维度的认知和行为变化在培训后明显改善,差异有统计学意义(P0.01)。结论ICU预防VAP循证护理培训能有效提高护士的认知和行为水平,同时促进了预防VAP循证护理的全面推广和应用,使护理质量内涵得到大幅度提高,也为ICU专科培训和继续教育提供了反馈指导和经验借鉴。

Effect of the evidence-based nursing educational programme for preventing ventilator-associated pneumonia in critical care nurses

Objective To establish the evidence-based nursing educational programme for preventing ventilator-associated pneumonia (VAP) and evaluate the effects in critical care nurses. Methods The evidence-based nursing practice guidelines for preventing VAP from 2008 American Association of Critical Care Nurses was used as training materials,which guided the curriculum design. Seventeen critical care nurses were trained. The difference of the nurses' knowledge and practice was evaluated before and after training by an evaluation scale of nursing quality criteria for preventing VAP. Results After the training,nurses' knowledge and practice of preventing VAP were improved(Z=-3.624,P=0.000). Except the factor score of handwashing,there were significant differences on the factor scores of body position care,endotracheal tube care,enteral nutrition,maintaining the tube cuff pressure,oral care and ventilator equipment management (P<0.01). Conclusion The educational programme of evidence-based nursing for preventing VAP can improve the nurses' knowledge and practice of preventing VAP. Furthermore,it can promote the application of evidence-based nursing for preventing VAP,and thereby to improve the quality of nursing,and provide guidance for the training of critical care nurses and continuing education.