중환자실 흡인간호 및 인공호흡기관리 표준화를 통한 인공호흡기 관련 폐렴발생 감소효과에 관한 연구

송경자; 유정숙; 권은옥; 정은자; 신현주; 박옥향; 옥순옥; 유미; 윤선희; 이복남; 최진아; 황정해; 오향순

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자료유형: 학술저널

저자정보: 송경자 (서울대학교병원 간호부) 유정숙 (서울대학교병원 간호부) 권은옥 (서울대학교병원 간호부) 정은자 (서울대학교병원 간호부) 신현주 (서울대학교병원 간호부) 박옥향 (서울대학교병원 간호부) 옥순옥 (서울대학교병원 간호부) 유미 (서울대학교병원 간호부) 윤선희 (서울대학교병원 간호부) 이복남 (서울대학교병원 간호부) 최진아 (서울대학교병원 간호부) 황정해 (서울대학교병원 QA전담반) 오향순 (서울대학교병원 감염관리실)

저널정보: 한국의료질향상학회 한국의료질향상학회지 한국의료질향상학회지 제8권 제1호

발행연도: 2001.1

수록면: 44 - 55 (12page)

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Background : This study aimed at identifying the effect of the standardized protocol on lowering the incidence of the ventilator associated pneumonia(VAP). Methods : The standard protocol focusing on decreasing VAP was made and applied at 5 ICUs (Medical ICU, surgical ICU, Respiratory ICU, Neonatal ICU, Pediatric ICU) in a university affiliated tertiary hospital, from April 1, 2000 to Oct 31, 2000. The protocol involved 3 parts : hand washing, the suctioning method and ventilator circuit management. All the nursing personnel received intensive education which was consisted of lecture, video film and demonstration. 176 nurses reported the performance of handwashing pre and post intervention. And randomly selected 15 nurses were observed by charge nurse and the handwashing practice was analyzed pre and post intervention. The incidence of VAP was compared with the former year incidence. Results : The self reported frequency of hand washing increased. In the direct observation of handwashing, the frequency, time, thoroughness of hand washing during 8 hours day duty was found to be improved. The frequency was increased from 1.1 time to 4.1 times; the time was improved from 1.7 seconds to 5.7 seconds and the thoroughness of the washing practice was from 0.2 times to 3.0 times respectively (p<0.001). The incidence of VAP decreased from at a rate of 15.63 number of case per 1,000 ventilator-day (April 1~August 31, 1999) to 7.23 number of case per 1,000 ventilator-days(April 1~Oct 31, 2000)(P<0.001). Conclusion : We developed the protocols which included hand washing, the suctioning method, and ventilator circuit management. Through the implementation of the protocol, the performance of hand washing improved and the VAP incidence rate in ICU was decreased.

#Ventilator associated pneumonia #Handwashing #Suction #Ventilator

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