ICU护士呼吸机相关性肺炎预防措施知信行及影响因素调查

黄其东; 郑雷雷; 张其霞; 卫庆; 陈瑜

doi:10.16766/j.cnki.issn.1674-4152.003521

ICU护士呼吸机相关性肺炎预防措施知信行及影响因素调查

doi: 10.16766/j.cnki.issn.1674-4152.003521

1.
温州医科大学附属第一医院330病区重症医学科，浙江温州 325000
2.
温州医科大学附属第一医院呼吸与危重症医学科
3.
温州医科大学附属第一医院护理部

基金项目:

浙江省卫生健康科技计划项目 2024KY1247

温州市科学技术局项目 Y20210596

详细信息

通讯作者:
陈瑜，E-mail：chenxiaolongwy@126.com

中图分类号: R192.6 R563.1
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出版历程
- 收稿日期: 2023-11-15
- 网络出版日期: 2024-07-20

Investigation of knowledge, attitudes, and behaviors regarding ventilator-associated pneumonia prevention measures and influencing factors among ICU nurses

1.
Section 330, Department of Critical Care Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China

摘要

摘要: 目的了解浙江省某三级甲等医学重症监护病房护士呼吸机相关性肺炎的知识、态度、行为现状及其影响因素，为提高重症监护病房护士对呼吸机相关性肺炎的护理技能提升提供理论依据。方法于2023年5月，采用自制调查问卷整群抽取浙江省某三级甲等医院重症监护病房全部护士148名进行调查。结果浙江省某三级甲等医院ICU护士VAP知识在知识维度得分为(16.16±1.82)分，在态度维度得分为(100.01±13.86)分，在行为维度得分为(31.33±4.28)分。多元线性回归分析结果显示，在知识维度方面，管理岗相较于责任岗与知识得分呈正相关关系(P＜0.05)，文化程度和从事ICU护理工作的年限(年)与知识得分均呈负相关关系(P＜0.05)；在态度维度方面，从事ICU护理工作的年限(年)与态度评分呈正相关关系(P＜0.05)；在行为维度方面，管理岗和教学岗相较于责任岗，与行为评分均呈负相关关系(P＜0.05)。结论浙江省某三级甲等医院重症监护病房护士呼吸机相关性肺炎的知识处于较高水平，但态度和行为水平仍有待提升。建议增加呼吸机相关性肺炎预防措施相关知识的教育工作。
- 呼吸机相关性肺炎 /
- ICU护士 /
- 认知行为
Abstract: Objective To understand the knowledge, attitude, behavior status, and influencing factors of ventilator-associated pneumonia among nurses in a tertiary A medical intensive care unit in Zhejiang Province, and to provide a theoretical basis for improving the nursing skills of nurses in intensive care units for ventilator-associated pneumonia. Methods In May 2023, a self-made survey questionnaire was used to cluster select 148 nurses from the intensive care unit of a tertiary A hospital in Zhejiang Province for investigation. Results ICU nurses from a tertiary A hospital in Zhejiang Province scored 16.16±1.82 in terms of VAP knowledge in the knowledge dimension, 100.01±13.86 in the attitude dimension, and 31.33±4.28 in the behavior dimension. The results of multiple linear regression analysis showed that in terms of knowledge dimension, management positions showed a positive correlation trend with knowledge scores compared to responsibility positions (P<0.05), while education level and years of working in ICU nursing showed a negative correlation trend with knowledge scores (P<0.05); In terms of attitude dimension, there is a positive correlation between years of experience in ICU nursing work and attitude scores (P<0.05); In terms of behavioral dimensions, management and teaching positions show a negative correlation with behavioral scores compared to responsibility positions (P<0.05). Conclusion The knowledge of ventilator-associated pneumonia among nurses in the intensive care unit of a tertiary A hospital in Zhejiang Province is at a high level, but their attitudes and behavioral levels still need to be improved. Suggest increasing education on the prevention measures for ventilator-associated pneumonia.
- Ventilator-associated pneumonia /
- ICU nurses /
- Cognitive behavior

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表 1 不同特征浙江省某三级甲等医院ICU护士VAP知识知信行各维度得分情况比较(分)

Table 1. Comparison of scores in various dimensions of VAP knowledge, attitudes, and practices among icu nurses at a tertiary Grade-A hospital in Zhejiang Province

特征	例(%)	知识评分	统计量	P值	态度评分	统计量	P值	行为评分	统计量	P值
性别			-1.497^a	0.134		-1.675^a	0.094		-0.471^a	0.638
男性	15(10.1)	16.00(14.00, 16.00)			91.00(86.00, 106.00)			33.00(22.00, 36.00)
女性	133(89.9)	17.00(15.00, 18.00)			101.00(94.00, 106.00)			31.00(30.00, 33.00)
年龄(岁)			1.911^b	0.063		0.903^a	0.637		1.014^b	0.451
＜25	41(27.7)	16.07±1.82			102.00(94.00, 106.00)			30.24±3.84
25~30	55(37.2)	16.16±1.81			99.00(90.00, 104.00)			31.67±4.03
30~40	38(25.7)	16.16±1.87			100.00(94.00，107.00)			32.26±5.02
≥40	14(9.5)	16.43±1.91			107.00(92.00, 113.00)			30.64±3.88
文化程度			32.703^c	＜0.001		0.513^c	0.774		6.827^c	0.033
中专	12(8.1)	18.00(17.00, 18.00)			104.00(91.00, 109.00)			30.00(29.00, 31.00)
大专	45(30.4)	18.00(17.00, 18.00)			102.00(96.00, 106.00)			30.00(29.00, 33.00)
本科及以上	91(61.5)	16.00(15.00, 17.00)			99.00(91.00, 107.00)			31.00(30.00, 334.00)
ICU护士准入资格证书级别			2.896^b	0.005		0.564^c	0.754		1.513^b	0.088
院级	58(39.2)	15.71±1.71			99.00(91.00, 106.00)			31.72±4.67
省级	73(49.3)	16.40±1.75			102.00(94.00, 106.00)			31.41±4.27
国家级	17(11.5)	16.71±2.26			103.00(91.00, 109.00)			29.65±2.15
目前岗位类别			17.737^c	＜0.001		3.193^c	0.203		11.307^c	0.004
责任岗	112(75.7)	16.00(15.00-18.00)			100.00(92.00, 106.00)			32.00(30.00, 33.00)
管理岗	23(15.5)	18.00(17.00, 18.00)			106.00(95.00, 108.00)			30.00(28.00, 31.00)
教学岗	13(8.8)	18.00(17.00, 18.00)			98.00(91.00, 106.00)			30.00(29.00, 30.00)
婚姻状态			8.604^c	0.014		0.110^c	0.578		0.530^c	0.071
未婚	62(41.9)	16.00(15.00, 18.00)			99.00(94.00, 105.00)			31.00(30.00, 33.00)
已婚	78(52.7)	16.00(15.00, 18.00)			102.00(92.00, 108.00)			31.00(30.00, 33.00)
离异	8(5.4)	18.00(17.00, 18.00)			101.00(89.00, 104.00)			30.00(29.00, 30.00)
工作年限(年)			1.386^b	0.208		0.793^b	0.526		9.412^c	0.024
＜5	65(43.9)	16.32±1.71			97.65±15.22			31.00(29.00, 33.00)
5~10	41(27.7)	15.73±1.88			101.61±12.64			33.00(31.00, 33.00)
10~15	24(16.2)	16.13±2.07			98.46±10.92			31.00(28.00, 34.00)
≥15	18(12.2)	16.61±1.69			107.00±13.03			31.00(30.00, 35.00)
从事ICU护理工作的年限(年)			2.274^b	0.026		8.146^c	0.043		5.037^c	0.169
＜5	80(54.1)	16.19±1.74			99.00(91.00, 105.00)			31.00(29.00, 33.00)
5~10	41(27.7)	16.27±1.78			102.00(93.00, 107.00)			33.00(30.00, 33.00)
10~15	18(12.2)	15.89±2.32			103.00(91.00, 111.00)			30.00(28.00, 36.00)
≥15	9(6.1)	16.00±1.94			108.00(104.00, 126.00)			31.00(31.00, 37.00)
所在ICU性质			-1.495^c	0.135		-0.396^a	0.692		-1.201^a	0.230
综合ICU	96(64.9)	17.00(15.00, 18.00)			100.00(92.00, 107.00)			31.00(29.00, 33.00)
专科ICU	52(35.1)	16.00(15.00, 18.00)			102.00(93.00, 106.00)			31.00(30.00, 34.00)
职称			1.568^b	0.140		0.768^b	0.829		8.080^c	0.044
护士	40(27.0)	16.43±2.04			99.80±7.78			30.00(29.00, 33.00)
护师	61(41.2)	15.92±1.65			98.39±17.09			32.00(30.00, 33.00)
主管护师	39(26.4)	16.21±1.84			102.38±12.74			31.00(28.00, 36.00)
副主任护师及以上	8(5.4)	16.50±2.00			101.88±15.99			31.00(29.00, 33.00)
近3个月内受到关于VAP相关知识的次数(次)			4.327^c	0.115		4.897^c	0.086		1.207^c	0.547
＜3	96(64.9)	16.00(15.00, 18.00)			103.00(93.00, 107.00)			31.00(30.00, 33.00)
3~5	44(29.7)	17.00(15.00, 18.00)			99.00(92.00, 104.00)			31.00(29.00, 33.00)
≥5	8(5.4)	15.00(13.00, 17.00)			91.00(81.00, 105.00)			33.00(25.00, 37.00)
注：^a为Z值，^b为F值，^c为H值。

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表 2 148名不同特征浙江省某三级甲等医院ICU护士VAP知识知信行得分的多元线性回归分析

Table 2. Multivariate linear regression analysis of VAP knowledge, attitudes, and practices scores among 148 ICU nurses with diverse characteristics in a tertiary hospital in Zhejiang Province

变量	B	SE	β'	t值	P值
知识维度
文化程度	-0.917	0.256	-0.324	-3.575	＜0.001
管理岗	1.129	0.519	0.225	2.177	0.031
教学岗	0.847	0.591	0.132	1.433	0.154
从事ICU护理工作的年限(年)	-0.642	0.221	-0.319	-2.906	0.004
态度维度
从事ICU护理工作的年限(年)	3.156	1.238	0.206	2.550	0.012
行为维度
管理岗	-3.898	1.278	-0.331	-3.049	0.003
教学岗	-3.610	1.380	-0.240	-2.616	0.010
职称	1.206	0.584	0.243	2.064	0.041
注：各变量赋值情况如下，性别：男性=1，女性=2；年龄(岁)：＜25=1；25~＜30=2，30~＜40=3，≥40=4；文化程度：中专=1，大专=2，本科及以上=3；ICU护士准入资格证书：院级=1，省级=2，国家级=3；工作年限(年)：＜5=1，5~＜10=2, 10~＜15=3, ≥15=4；从事ICU护理工作的年限(年)：＜5=1，5~＜10=2, 10~＜15=3, ≥15=4；所在ICU性质：综合ICU=1，专科ICU=2；职称：护士=1，护师=2，主管护师=3，副主任护师及以上=4；近3个月内接受到关于VAP相关知识的次数(次)：＜3=1, 3~＜5=2, ≥5=3。对于目前岗位类别及婚姻状态分别设置哑变量，岗位类别中责任岗=(0, 1, 0)，管理岗=(1, 0, 0)，教学岗=(0, 0, 1)；婚姻状态中，未婚=(0, 1, 0)，已婚=(1, 0, 0)，离异=(0, 0, 1)。

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