Study On The Status Of Cognitive Implementation And Intervention Of Preventive Measures For Ventilator Associated Pneumonia Of ICU Nurses

Objective: To understand the ICU nurses,status of cognitive implementation and clinical compliance about ventilator-associated pneumonia(VAP)preventive measures in the general tertiary hospital of Urumqi,we used habit formation theory to intervene and evaluate the intervention effect of ICU nurses.Methods: 680 ICU nurses were chosen,in conformity with the inclusion criteria by the questionnaire of VAP prevention measures on cognitive behavior and influencing factors,for investigation.The clinical compliance of one ICU nurses were monitored for one month by the monitoring table of the prevention measures in ICU.The two groups of ICU nurses who met the inclusion criteria were given conventional and customary formation theory intervention respectively.The changes of cognition behavior and clinical compliance of the two groups after intervention were compared.Results:(1)The standardized scores of knowledge,attitude,behavior and total score of VAP prevention measures for ICU nurses were(50.34±10.10),(69.45±4.42),(85.54±11.32)and(72.91±5.03)respectively.The three scores of knowledge,attitude and behavior were positive relevant.(2)The compliance rate of ventilator / exchanger replacement,on-demand suction of ICU nurses were the highest,amounting to more than 97%;the compliance rate of oral care,hand hygiene compliance and sedative effects were 50%-67%;the compliance rate of daily wake and spontaneous breathing test,early rehabilitation,head elevation,air condensed water pressure monitoring and the dumping were low,less than 30%.(3)After the intervention of habit formation theory,the scores of knowledge,attitude and behavior within,between and the difference of the two groups were statistically significant(P<0.01),the scores of knowledge,attitude,behavior and the total score were higher than the control group.(4)Comparison of the compliance within the group in different periods after the intervention,the compliance rate of sedative effect,daily wake and spontaneous breathing test,early rehabilitation,head elevation,condensed water dumping,oral care,hand hygiene,air pressure monitoring had significant difference(P<0.05);comparison between groups,the compliance rate of sedative effect,ventilator / exchanger replacement,daily wake and spontaneous breathing test,early rehabilitation,condensed water dumping,head elevation,air pressure monitoring had significant difference(P<0.05).With the prolongation of the time of the intervention,the compliance of the two groups showed a growing trend(except for ventilator / exchanger replacement and sputum sucking on demand).After the intervention for 7 days,14 days,21 days,1 months of the experimental group,the compliance rate of sedative effect,daily arousal,early rehabilitation,head elevation,condensed water dumping,oral care,hand hygiene and aerocyst pressure monitoring compliance had significant difference(P<0.05);after 2 and 3 months,the compliance rate of ventilator / exchanger replacement,sputum suction nursing,sedative effect,daily wake and spontaneous breathing test,early rehabilitation,condensed water dumping,head,hand hygiene had no significant difference(P>0.05),after 2-3 months of intervention,the compliance of VAP preventive measures and the total compliance in the test group grew stably.Conclusion:(1)The knowledge level of VAP prevention measures among ICU nurses in Urumqi large general tertiary hospital was low,and attitude and behavior need to be improved.(2)The clinical compliance of ICU nurses of VAP prevention measures was not optimistic.(3)Routine intervention and habit formation theory intervention can improve the level of cognitive behavior and clinical compliance of VAP prevention measures of ICU nurses in different ways,and the effect of habit formation theory intervention was better than that of routine intervention.