The Impact Of Invasive Ventilator Circuit Changes Interval On The Occurrence Of Ventilator-associated Pneumonia

Objective:To understand comprehensively the present status of ICU nurses in the general hospitals in Shanxi Province and the mastery and demand status of ICU nurses' knowledge about the circuit changes of invasive ventilators,and to explore the possible reasons for inconsistent implementation of circuit changes interval.And provide the basis for the circuit changes interval.In addition,the influence of the changes interval of the invasive ventilator circuit system on the occurrence of ventilator-associated pneumonia was discussed,so as to provide reference for the clinical practice.Methods:(1)In the survey research,after a review of relevant literature at home and abroad,designing a questionnaire on their own,taking two ways of on-site issuance and mailing,selecting randomly 13 hospitals' ICU nurses to investigate about the invasive circuit changes interval in Shanxi Province.(2)In the case-control study,from April 15,2015 to October 14,2015 and from October 15,2015 to April 14,2016 admitted to a top three General Hospital Department of Neurology ICU,Neurosurgery ICU and Respiratory ICU patients with invasive mechanical ventilation were set as the control group 1 and control group 2,ventilator circuit changes once every 7 days.From April 15,2016 to October 14,2016 patients set to the case group,only if the circuit visibly soiled or malfunctioning to be changed.Results:(1)Questionnaire survey resultsSurveyed 34 ICU nurses,distributed 724 questionnaires and 717 valid questionnaires,the effective rate was 99.03%.A unified circuit changes interval of ICU accounted for73.8%.ICU nurses currently provisions and practical implementation of circuit changes interval tend to 7d.Different rules and ICU nurses actually change circuit weresignificantly different(x2=24.84 and 35.76,p<0.01).(2)Case-control study resultsThe age,inflammatory markers before mechanical ventilation,the positive rate of sputum examination during mechanical ventilation and the incidence of Ventilator-associated Pneumonia had no significant differences in the case group and the control group(P>0.05).Conclusion:(1)Hospitals should choose the right way to strengthen the ICU nurses circuit changes training interval and knowledge,to develop the term for their own security environment,thereby reduce the workload of nurses,reduce medical costs and improve care service quality.(2)Circuit changes only if visibly soiled or malfunctioning does not affect the patient's prognosis and can significantly reduce the frequency of exchanging circuit as well as the economic burden.Recommending circuit to be changed only if visibly soiled or malfunctioning.