Quality Improvement in Health Care (한국의료질향상학회지)

Korean Society for Quality in Health Care (한국의료질향상학회)
권호 표지

The Effects of Standardized Suction and Ventilator Management Protocol on Ventilator Associated Pneumonia in the Intensive Care Unit

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

  • Song, Kyung Ja (Nursing Department, Seoul National University Hospital) ;
  • Yoo, Cheong Suk (Nursing Department, Seoul National University Hospital) ;
  • Kwon, Eun Ok (Nursing Department, Seoul National University Hospital) ;
  • Jung, Eun Ja (Nursing Department, Seoul National University Hospital) ;
  • Shin, Hyeon Ju (Nursing Department, Seoul National University Hospital) ;
  • Park, Ock Hyang (Nursing Department, Seoul National University Hospital) ;
  • Ok, Sun Ok (Nursing Department, Seoul National University Hospital) ;
  • Yu, Mi (Nursing Department, Seoul National University Hospital) ;
  • Yun, Sun Hee (Nursing Department, Seoul National University Hospital) ;
  • Lee, Bok Nam (Nursing Department, Seoul National University Hospital) ;
  • Choi, Jin Ah (Nursing Department, Seoul National University Hospital) ;
  • Hwang, Jeong Hae (QA team, Seoul National University Hospital) ;
  • Oh, Hyang Soon (Infection Control Service, Seoul National University Hospital)
  • 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)
  • Published : 2001.06.24
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Abstract

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.

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