無滴入生理食鹽水之抽痰術降低呼吸器相關肺炎之研究

Reducing Ventilator-Associated Pneumonia (VAP) by not Using Instillation Saline before Suctioning

10.6225/JNHR.08.4.325

賴美玉(Mei-Yu Lai)；張淑華(Shu-Hua Chang)；宋怡憓(Yi-Hui Sung)

生理食鹽水 ； 抽痰術 ； 呼吸器相關肺炎 ； saline ； suctioning ； ventilator-associated pneumonia

護理暨健康照護研究

8卷4期（2012 / 12 / 01）

325 - 331

繁體中文

Background: Ventilator-associated pneumonia (VAP) has been shown to increase total number of ventilatordependent days and increase medical costs. Although using instillation saline prior to endotracheal suctioning induces nausea in some patients, it remains a common practice with ventilator-dependent patients. To improve this situation, we used an evidence-based method to assess the potential relationship between instillation saline and VAP.Purpose: This study compared VAP incidence rates between patients receiving instillation saline and those who did not prior to endotracheal suctioning.Methods: Purposive sampling was conducted in the intensive care unit of a medical center. Data on the instillation saline (control) group (n = 81) were collected for 6 months, followed by 6 months of data collection on the noinstillation saline (experimental) group (n = 116). We compared collected data to indentify differences in VAP incidence between the two.Results: VAP was diagnosed on average at day 28.0 for the experimental group and at day 10.8 for the control group. The VAP incidence rate was 1.31 1 per mille for the experimental group and 9.19 1 per mille for the control group. A t -test found both differences to be statistically significant (p ＜ .05).Conclusions: Not using instillation saline before endotracheal suction was found to significantly decrease VAP incidence and reduce medical expenditures.

Background: Ventilator-associated pneumonia (VAP) has been shown to increase total number of ventilatordependent days and increase medical costs. Although using instillation saline prior to endotracheal suctioning induces nausea in some patients, it remains a common practice with ventilator-dependent patients. To improve this situation, we used an evidence-based method to assess the potential relationship between instillation saline and VAP.Purpose: This study compared VAP incidence rates between patients receiving instillation saline and those who did not prior to endotracheal suctioning.Methods: Purposive sampling was conducted in the intensive care unit of a medical center. Data on the instillation saline (control) group (n = 81) were collected for 6 months, followed by 6 months of data collection on the noinstillation saline (experimental) group (n = 116). We compared collected data to indentify differences in VAP incidence between the two.Results: VAP was diagnosed on average at day 28.0 for the experimental group and at day 10.8 for the control group. The VAP incidence rate was 1.31 1 per mille for the experimental group and 9.19 1 per mille for the control group. A t -test found both differences to be statistically significant (p ＜ .05).Conclusions: Not using instillation saline before endotracheal suction was found to significantly decrease VAP incidence and reduce medical expenditures.