降低某兒科加護病房開心術後呼吸器相關性肺炎感染密度專案

Ventilator-Associated Pneumonia (VAP) in a PICU

賴宥言(Yu-Yen Lai) ； 蔡美娟(Mei-Chuan Tsai) ； 蘇俞萍(Yu-Ping Su) ； 陳惠貞(Hui-Chen Chen)

《榮總護理》 31卷1期 (2014/03) Pp. 73-82

https://doi.org/10.6142/VGHN.31.1.73

摘要

本專案旨在降低兒科加護病房開心術後呼吸器相關性肺炎（Ventilator-associated Pneumonia，VAP）感染密度。本單位2010年6至12月發生VAP總人數共7人，月感染密度最高值為千分之38.5，較同年1至6月感染密度最高值千分之13.9，增加近3倍，經分析主因有：缺乏VAP在職教育；無整體性呼吸道照護稽核制度；缺乏呼吸道照護相關用物清潔與消毒規範。藉由多元性的在職教育、以整體性稽核制度、修制訂相關照護規範等改善方案，落實感控原則。專案實施後，2011年每月VAP感染密度有效降低至千分之17以下，且VAP年感染密度降至千分之3.1，達成本專案目標，有效提升照護品質。

關鍵字

兒科加護病房 ； 開心手術 ； 呼吸器相關性肺炎

並列摘要

This project aims to reduce the infection density of ventilator-associated pneumonia (VAP) after receiving heart surgeries within the pediatric intensive care unit (PICU). During June to December 2010, seven were found infected with VAP, with infection density value at 38.5%, which was almost three times as high as the January-June period where the infection density was much lower at 13.9%. The main reasons are: lack of VAP related in-service training, no combined care norms and auditing procedure, and lack of respiratory care related material cleaning and sterilize procedures. The ad hoc group established the followings for improvement on this matter: (a) Conduct VAP related in-service training, (b) Formulate an overall performance auditing procedure, (c) Establish cleaning and sterilizing procedures for equipments used during respiratory care. After the implementation of the above suggestions, this project has successfully reduced the monthly density of VAP infection to 17% or less during the year 2011, with an annual infection rate of 3.1%. Hence, by achieving the goal of this project and reducing VAP infection density rates, we have significantly and effectively improve the quality of care.

並列關鍵字

pediatric intensive care unit (PICU) ； heart surgery ； ventilator-associated pneumonia (VAP)