Study On The Effect Of Early Standardized Functional Exercise On Improving Mechanical Ventilation Time In Critically Ill Patients

Objective To evaluate the level of early functional exercise,knowledge,belief and practice of intensive care unit nurses and to analyze its influencing factors;to explore the early functional exercise standardization program and its application effect in patients with mechanical ventilation in ICU.Methods1.In May 2017,252 ICU nurses in five top three hospitals in Jiangsu Province were selected as the research objects.The questionnaire included 25 items of ICU nurses' knowledge,attitude and behavior on early functional exercise.2.The historical control design method was adopted,and 112 cases of mechanical ventilation patients who were admitted to the Eastern Theater General Hospital from December 2017 to November 2018 were selected for the mechanical ventilation who met the inclusion criteria.Research object.The control group followed the routine care of ICU patients with mechanical ventilation.The experimental group adopted the routine care of ICU patients with mechanical ventilation combined with early functional exercise programs.The mechanical ventilation time,albumin index,ICU hospital stay,ventilator associated pneumonia incidence and adverse events were compared between the two groups of patients.Results1.ICU nurses' early functional exercise knowledge score(21.15 ± 4.15),attitude score(34.23 ± 4.29),The scores of early functional exercise knowledge scores of ICU nurses with different ages,titles and ICU working years were statistically significant(P <0.05);the scores of early functional exercise attitude scores of ICU nurses with different ages,educational backgrounds,job titles and ICU working years were statistically significant(P <0.05);Early functional exercise behavior scores of ICU nurses with different ages,job titles,ICU working years and ICU department categories were statistically significant(P <0.05).The results of multiple linear regression analysis show that the main factor affecting ICU nurses' early functional exercise knowledge is ICU working years;the main factor affecting ICU nurses' early functional exercise attitude is job titles;the main factors affecting ICU nurses' early functional exercise behaviors are ICU working years and ICU department category.2.A total of 112 ICU patients with mechanical ventilation were included.Compared with the control group with mechanical ventilation time of(76.59 ± 31.39)h,the experimental group had a mechanical ventilation time of(63.36 ± 37.75)h.The difference was statistically significant(P<0.05);The analysis of variance of repeated measurement of albumin indicators showed that the effects between groups and time were statistically significant(P < 0.01),and the interaction effects were not statistically significant(P>0.05).A further pairwise comparison showed that there was a significant difference in albumin between the two groups of patients on the third,fifth,and seventh days of ICU admission(P<0.05);The ICU hospitalization time in the test group was(18.91 ± 7.67)d and the ICU hospitalization time in the control group was(23.57 ± 11.05)d,the difference was statistically significant(P<0.05);the VAP incidence rate in the test group was 3.6% and the VAP incidence rate in the control group Compared with 14.3%,the difference was statistically significant(P<0.05);During the activity,one patient in the control group experienced a heart rate of more than 130 beats / min,and two patients experienced a decrease in blood oxygen saturation to 85%.One patient in the test group had shortness of breath,respiratory rate greater than 40 beats per minute,and no adverse events such as tube slippage,skin damage,and malignant arrhythmia occurred during functional exercise.Conclusion1.ICU nurses have a more positive attitude towards early functional exercise,but their cognitive and behavioral conditions are not very optimistic.Relevant knowledge training should be strengthened,a sound and relevant nursing quality evaluation system should be established,and in-depth research and discussion should be conducted to intervene in patients with ICU mechanical ventilation.Effect of measures;improve and formulate safety management system and standardized process in the intervention process.2.Application of mechanically ventilated patients in the ICU early exercise standardized processes and shorten the duration of mechanical ventilation,improve nutrition,reduce the incidence of VAP,Reduced ICU hospital stay.