인공호흡기 관련 폐렴 예방 프로그램이 폐렴 발생률과 기관내 균집락화에 미치는 효과

Purpose: This study examined the effects of a program designed to prevent ventilator-associated pneumonia (VAP) on VAP rate and endotracheal colonization. The program focused on aspiration prevention and oral care. Methods: A nonequivalent control group post-test only design was utilized. One hundred patients admitted to a medical intensive care unit (MICU) or coronary care unit (CCU) were assigned to either a experimental group (n=50) or a control group(n=50). The participants were selected 48 hours following an endotracheal intubation. VAP prevention program given to the experimental group includes keeping the head of the bed to 30°~45° high, maintaining continuous endotracheal cuff pressure at 25 cm H₂O, performing endotracheal suction before change position, and providing oral care with 0.1% chlorhexidine every four hours. The control group received usual care. Data were analyzed using t-test, x 2 test, Mantel-Haenszel x 2 and Cox proportional harzard regression model. Results: The experimental group showed a lower VAP rate than the control group although the difference was not statistically significant (x 2 =0.79, p=.375). The experimental group showed lower colonization in tracheal secretion than the control group (x 2 =14.59, p<.001). Conclusion: Results showed that a VAP prevention program is effective in reducing colonization of tracheal secretion. Therefore, VAP prevention programs are recommended as an ICU nursing intervention.