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首页> 外文期刊>Nurse Media: Journal of Nursing >Management for Preventing Ventilator-Associated Pneumonia at ICU Panti Rapih Hospital: A Clinical Case Study
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Management for Preventing Ventilator-Associated Pneumonia at ICU Panti Rapih Hospital: A Clinical Case Study

机译：ICU Panti Rapih医院预防呼吸机相关性肺炎的临床案例研究

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Background : Ventilator-Associated Pneumonia (VAP) is one kind of nosocomial infection that happens to patients who use mechanical ventilator and tracheostomy. Patients who are hospitalized in Intensive Care Unit (ICU) would have high risk onsuffering from Pneumonia. Objective : This paper aims to describe the interventions of nurses and to give recommendations for managing the VAP prevention using case study method. Methods : The data were collected from a patient who used mechanical ventilator and continued by observing and interviewing the nurses who took care of the patient. Results : The development of late onset of VAP was noticed after 96 hours. The observation result showed that there were fungi appeared after conducting a sputum culture from the patient. There was an increase of White Blood Cells on 72 hours after the intubation and the temperature increased until 37o C while the patient was using ventilator. Unfortunately, the nurses were not aware of the tendency of late onset VAP development in the patient. Discussion : Fungi are microorganism which causes VAP. The fungi were not proliferating because the patient had received early antibiotics for treatment. Early administration of antibiotics will prevent the development of VAP, but late VAP is associated with antibiotic-resistant organism. The significant increase of WBC count and the tendency of temperature while the patient was using ventilator were signs for developing infection. VAP can be prevented by conducting good oral hygiene every 2 hours using chlorhexidine 0.12% and using orogastric tube and ETT with sub glotticport to patients who use mechanical ventilator. Furthermore, positioning the patient’s head with 35o - 45o bed elevation is intended to prevent aspiration as well as checkingadequate endotracheal tube cuff of at least 20 cm H2. Conclusion : Awareness, responsibility, knowledge, skills of nurses are basis forinfection control especially for preventing VAP incidents.
机译：背景：呼吸机相关性肺炎（VAP）是一种医院感染，发生在使用机械呼吸机和气管切开术的患者中。重症监护病房（ICU）住院的患者遭受肺炎的风险较高。目的：本文旨在描述护士的干预措施，并为通过案例研究方法管理VAP预防提供建议。方法：数据收集自使用机械呼吸机的患者，然后继续观察和采访照顾患者的护士。结果：96小时后发现VAP发作较晚。观察结果表明，患者进行痰培养后出现真菌。插管后72小时白细胞增加，直到患者使用呼吸机时温度升高至37oC。不幸的是，护士们并未意识到患者中迟发性VAP发生的趋势。讨论：真菌是引起VAP的微生物。真菌未增殖，因为患者已接受早期抗生素治疗。尽早使用抗生素可以预防VAP的发展，但晚期VAP与耐药菌有关。当患者使用呼吸机时，白细胞计数显着增加和体温变化趋势是感染的征兆。对于使用机械呼吸机的患者，每隔2小时使用0.12％的洗必泰进行良好的口腔卫生，并使用口胃管和ETT声门下的ETT可以预防VAP。此外，将患者头部放置在床高35o-45o的位置，以防止抽吸以及检查至少20 cm H2的气管插管是否足够。结论：护士的意识，责任感，知识和技能是感染控制的基础，尤其是预防VAP事件的发生。

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