Objective To explore the value and significance of respiratory nursing management mode on preventing pulmonary infection of severe hepatitis patients.Methods One hundred and sixty-eight severe hepatitis patients in hospital from 2008 to 2012 were enrolled.A total of 84 cases were randomized into control group,which were cared with traditional second-level monitoring mode:head nurse guidance,nursing department supervision.While for the 84 cases in prevention group,specialist nursing management group were established to organize regular patients nursing round,formulated nursing quality standards and evaluation indexes,and the cases were all cared by three-tier process monitoring:basic charge nursing,specialist group guidance,and nursing department supervision.Finally,the difference in pulmonary infection rate (PIR),infection related mortality (IRM),average length of stay (ALOS),and per capita hospitalization costs (PCHC) between the two nursing mode groups were evaluated.Results Compared with control group,the PIR significantly decreased 20.24％ in prevention group (x2 =8.537 4,P =0.003 5),and IRM were also decreased significantly (10.71％ vs 23.81％ ; x2 =5.042 9,P =0.024 7).ALOS were 38.09 days in prevention group and 51.24 days in control group,and PCHC decreased about ￥ 9 300.00 in prevention group.Conclusions Respiratory specialist nursing management mode is worth popularizing as it can prevent pulmonary infection,lessen IRM,shorten ALOS,and decrease PCHC,as well as can improve patients' satisfaction and compliance.%目的 探讨呼吸道护理管理小组在预防重型肝炎继发肺部感染中的作用.方法 将2008-2012年住院诊治的168例重型肝炎患者按照随机数字表法随机分为两组:常规组84例,采用护士长查房指导,护理部督导二级监控护理模式；预防组84例,在常规护理模式基础上建立呼吸道护理管理小组专员,定期组织查房、制定护理质量标准与评价指标、建立三级护理全程监控.比较两种护理模式下两组重型肝炎患者肺部感染发生率、感染相关病死率以及平均住院日、人均住院费用差异.结果 与常规组的38.10％相比,预防组患者肺部感染发生率(17.86％)下降20.24％,差异有统计学意义(x2=8.5374,P=0.0035),感染相关死亡率亦显著降低(10.71％比23.81％),差异有统计学意义(x2=5.0429,P =0.024 7)；预防组平均住院日为38.09 d,较常规组的51.24 d减少13.15 d,人均住院费用下降约9 300.00元.结论 呼吸道护理管理小组进行专门护理有利于预防重型肝炎肺部感染发生,降低病死率,缩短住院时间,减少住院费用.
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