تأثیر مداخله آموزشی بر عملکرد کارکنان پرستاری و میزان پنومونی وابسته به ونتیلاتور در بخش‌های مراقبت ویژه مرکز آموزشی درمانی حضرت علی‌ابن‌ابیطالب (ع) رفسنجان

نوع مقاله: مقاله پژوهشی

نویسندگان

1 دانشجوی کارشناسی ارشد، گروه پرستاری مراقبت‌های ویژه، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی رفسنجان، رفسنجان ، ایران.

2 مربی،گروه پرستاری داخلی و جراحی، دانشکده پرستاری و مامایی، مرکز تحقیقات عوامل اجتماعی مؤثر بر سلامت ،دانشگاه علوم پزشکی رفسنجان، رفسنجان، ایران.

3 استادیار، گروه مدیریت، دانشکده پرستاری و مامایی، مرکز تحقیقات سالمندی، دانشگاه علوم پزشکی رفسنجان، رفسنجان، ایران.

4 کارشناس ارشد فیزیولوژی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی رفسنجان، رفسنجان ، ایران.

5 مربی، گروه داخلی و جراحی، دانشکده پرستاری و مامایی، مرکز تحقیقات عوامل اجتماعی مؤثر بر سلامت. دانشگاه علوم پزشکی رفسنجان، رفسنجان، ایران.

10.22123/chj.2020.193208.1322

چکیده

مقدمه: پنومونی ناشی از ونتیلاتور، یک بیماری عفونی جدی در بخش مراقبت‌های ویژه در نظر گرفته می‌شود. آموزش پرستاران می­تواند موجب بهبود عملکرد و کاهش این نوع عفونت­ ­شود. مطالعه حاضر با هدف تعیین تأثیر آموزش بر میزان پنومونی ناشی از ونتیلاتور و عملکرد پرستاران بخش­های مراقبت­ویژه مرکز آموزشی درمانی حضرت علی­ابن­ابیطالب(ع) شهرستان رفسنجان انجام شد.
مواد و روش‌ها: در این مطالعه نیمه­تجربی، 62 پرستار بخش­های ویژه به روش در دسترس و بر اساس معیارهای ورود به مطالعه انتخاب شدند. ابتدا میزان پنومونی ناشی از ونتیلاتوردر طی سه ماه تعیین گردید و عملکرد پرستاران سنجیده شد. سپس در مورد چگونگی پیشگیری از این نوع پنومونی، آموزش­های لازم داده شد. پس از 3 ماه، مجدد میزان عملکرد و شیوع پنومونی ثبت گردید و داده­ها توسط آزمون­های تی­زوجی، فیشر و کولموگروف اسمیرنوف تجزیه ‌و تحلیل شد.
یافته‌ها: قبل از آموزش، از 45 بیمار که با ونتیلاتور تهویه مکانیکی می­شدند، 44 نفر (8/97%) و بعد از آموزش، از 37 بیمار، 33 نفر (2/89%) دچار پنومونی ناشی از ونتیلاتور شدند. تعداد پنومونی ناشی از ونتیلاتور بعد از آموزش نسبت به قبل، کاهش داشت اما این میزان از لحاظ آماری معنی‌دار نبود. عملکرد پرستاران از نظر دست شستن، ساکشن­کردن، کار با ونتیلاتور، تغییر وضعیت­دادن بیمار، پوشیدن گان، دهانشویه و لوله­گذاری داخل تراشه، بعد از آموزش نسبت به قبل آن، بهبود یافت و از لحاظ آماری معنی‌دار بود (05/0p<).
نتیجه‌گیری: این مطالعه نشان­داد آموزش پرستاران در زمینه پیشگیری از عفونت و پنومونی ناشی از ونتیلاتور می‌تواند مؤثر باشد، اگرچه این مداخله فقط تأثیر بالینی داشته است.

کلیدواژه‌ها


عنوان مقاله [English]

The impact of Educational Intervention on Nurses' Performance and Ventilator-associated Pneumonia Rate in Intensive Care Units of Rafsanjan Hospital

نویسندگان [English]

  • H Ganje 1
  • A Khodadadizadeh 2
  • SH Hoseini 3
  • M Mobini 4
  • A Akbari 5
1 MSc student, Dept of Critical Care Nursing, School of Nursing and Midwifery, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
2 Instructor, Dept of Medical-Surgical Nursing, School of Nursing and Midwifery, Social Determinants of Health Research Center, Rafsanjan University of Medical Sciences.Rafsanjan, Iran.
3 Assistant Prof, Dept of Nursing Management, School of Nursing and Midwifery, Geriatric Care Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
4 MSc of Physiology, School of Nursing and Midwifery, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
5 Instructor, Dept of Medical-Surgical Nursing, School of Nursing and Midwifery, Social Determinants of Health Research Center. Rafsanjan University of Medical Sciences,Rafsanjan, Iran.
چکیده [English]

Introduction: Ventilator-associated pneumonia (VAP) is considered a severe infectious disease in Intensive Care Units (ICUs). It seems that the teaching of nurses staff may improve the quality of care and reduce the VAP rate. This study is performed to determine the effect of education on VAP and nurses' performance in Rafsanjan ICUs.
Materials and Methods: The semi-experimental study was conducted on 62 intensive care nurses, who were selected through convenience sampling and inclusion criteria. VAP rate and nurses' performance were measured three months prior to intervention. Then, the necessary education about the methods of preventing such VAP took place. After three months, nurses' performance and VAP rates were measured again. Data were analyzed by SPSS software (V.18).
Results: The results showed that the VAP rate changes before(97.8%) and after the intervention (89.2%)were not statistically significant(p=1.000).Nurses' performance on hand washing, suctioning, patient position change, scrubs wearing, mouthwash, and intubation improved after training and had a statistically significant difference  (p<0/05).
Conclusions: The study indicated that nurses' education on the prevention of infection and VAP could be effective although this intervention had only clinical impact.

کلیدواژه‌ها [English]

  • Workshop
  • performance
  • Nurses
  • Ventilator-Associated Pneumonia (VAP)
  • Intensive Care Units
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