Construction Of Nursing Plan For Patients With Mechanical Ventilation Based On NNN Link And Clinical Empirical Study

Objective:The standardized nursing language NNN link was used as a theoretical basis to construct a nursing program for patients with non-invasive mechanical ventilation in respiratory failure,and the program was applied in the clinic to analyze the implementation effect of relevant nursing interventions and the clinical application effect of the program,and to provide a reference basis for the application of the standardized nursing language NNN link in the critical care specialty.Methods:（1）Literature review:preliminary screening of major nursing diagnoses,nursing outcomes and outcome indicators,and nursing interventions for patients with respiratory failure non-invasive mechanical ventilation.（2）Clinical participant observation and semi-structured interviews:supplementing nursing diagnoses and nursing interventions.（3）Delphi expert correspondence method:inviting experts to validate the initially formed nursing scheme,and finally forming a NNN link-based nursing scheme for patients with respiratory failure non-invasive mechanical ventilation.（4）Nursing care scheme based on NNN link construction for patients with respiratory failure non-invasive mechanical ventilation was applied to clinical practice,using the method of non-randomized controlled trial,patients with respiratory failure applying non-invasive mechanical ventilation who met the inclusion criteria in a tertiary care hospital in Xinjiang.From December 2021 to July 2022,patients were selected as study subjects.Patients from December 2021 to March 2022 were The control group was given conventional care;the patients from April 2022 to July 2022 were the test group,and the NNN link-based care program was given.We compared the changes in the nursing outcome scores of the patients in the test group before and after care,tested the effectiveness of the implementation of nursing interventions,and compared the blood gas analysis indexes,complications,duration of mechanical ventilation,length of ICU stay,and total hospital costs of the two groups.Results:（1）NNN link-based care protocol construction for patients with respiratory failure on noninvasive mechanical ventilation results:（1）Literature review initially screened 9 nursing diagnoses,15 nursing outcomes and 77 outcome indicators,and 31 nursing interventions related to patients with respiratory failure on noninvasive mechanical ventilation.（2）After clinical participatory observation and semi structured interview,1 nursing diagnosis,1 nursing outcome,4 outcome indicators,2 nursing interventions,and 6 suggested activities were supplemented.The initially constructed nursing plan includes 10 nursing diagnoses,16 nursing outcomes,81 outcome indicators,39 nursing interventions,and recommended activities.（3）The effective response rates of the two rounds of expert inquiry questionnaires were 100%and 88.89%,respectively.The expert opinion submission rates were 55.56%and 31.25%,respectively.The expert authority coefficients were 0.892 and 0.916,and the Kendall coordination coefficients were0.144～0.205.The final constructed NNN link-based care plan for patients with noninvasive mechanical ventilation in respiratory failure contained 7 nursing diagnoses,11 nursing outcomes and 38 outcome indicators,and 30 nursing interventions and suggested activities.（2）Clinical application results of nursing plan for patients with respiratory failure undergoing non-invasive mechanical ventilation based on NNN link:（1）among the 11 nursing outcomes,the scores of the remaining 10 nursing outcomes improved when the patients were transferred out of the ICU,except for tissue integrity:skin and mucous membranes（P<0.05）,indicating that the nursing interventions corresponding to these 10 nursing outcomes were effective,and the effective nursing interventions were a total of 26,which were:mechanical ventilation management:noninvasive,respiratory monitoring,assisted ventilation,etc.（2）There was no statistically significant difference between the blood gas analysis indexes of patients in the two groups before the intervention（P>0.05）,and the PH and Pa O₂values of patients in the test group were higher than those in the control group and Pa CO₂values were lower than those in the control group after the intervention（P<0.05）.（3）The complication rate of patients in the test group was lower than the complication rate of patients in the control group（P<0.05）.（4）The length of mechanical ventilation and ICU stay were lower in the test group than in the control group（P<0.05）.Conclusion:（1）The care plan for patients with non-invasive mechanical ventilation in respiratory failure constructed based on the NNN link has better reliability,scientificity and practicality,and promotes the development of the standardized nursing language NNN link in the field of intensive care specialties in China.（2）The care plan for patients with non-invasive mechanical ventilation in respiratory failure constructed based on the NNN link improved patient care outcomes and blood gas analysis indicators,reduced complication rates,and decreased the length of mechanical ventilation and ICU stay.