The Application Study On The Cluster-Based Nursing Intervention In The Treatment Of AECOPD Combined With Severe Respiratory Failure By Invasive-noninvasive Sequential Ventilation Therapy

Objective:The aim of this study was to compare the effects of routine nursing intervention with cluster-based nursing intervention in the treatment of chronic obstructive pulmonary disease with acute exacerbation(AECOPD) combined with severe respiratory failure by invasive-noninvasive sequential ventilation therapy, as well as the compliance and satisfaction of patients and their families with cluster-based nursing intervention, and to reveal the application value of cluster-based nursing intervention in the treatment of AECOPD combined with respiratory failure. Method:100 cases of AECOPD patients with severe respiratory failure were divided into randomized controlled trial group. The control group received routine nursing intervention and the research group received cluster-based nursing measures on the basis of routine nursing which prevent ventilator-associated pneumonia and were composed of six elements. Finally, the two groups were compared in terms of basic conditions and the effect of treatment(clinical data of laboratory data, duration of mechanical ventilation, the total length of stay, incidence of ventilator-associated pneumonia and re-intubation, etc.). Result:1. There was no significant difference of general case, blood gas analysis, hemogram before intubation and other data between the research group and the control group among 100 cases.(P> 0.05)2. There was no significant difference in blood gas analysis between the research group and the control group after 2 and 48 hours noninvasive sequential mechanical ventilation(P> 0.05), but the number of white blood cells and the changes were significantly(P <0.05) different which are compared PICW, after 2 hours and 48 hours with those before extubation. There was also no significant difference in lung function in PICW(P> 0.05).3. Man can find it from comparison with these two groups treatment effect of patients, that the invasive ventilatory time and total hospitalization time of the research group were significantly shorter than those of the control group(P <0.05)There was no significant difference in other indexes(invasive- noninvasive sequential mechanical ventilation time, total mechanical ventilation time, ICU ward time)(P> 0.05). The incidence of ventilator-associated pneumonia in the research group was significantly lower than that in the control group(P <0.05).4. There was significant difference in satisfaction and compliance of the patients and their families about nursing care between the research group and the control group(P <0.01), and the satisfaction and compliance of patients and their families with cluster-based management were higher. Conclusion:1. Cluster-based nursing intervention can reduce ventilator- associated pneumonia of AECOPD patients with respiratory failure, reduce the use of ventilator time and shorten the length of stay.2 Implementation of six cluster-based projects of cluster-based nursing measures is generally low in the routine care measures. But the cluster-based care measures can improve the satisfaction and compliance of patients and their families.3. Busy work and lack of awareness and training are the main reasons for the lack of effective implementation of cluster-based care measures.