:::

詳目顯示

回上一頁
題名:手術後病人使用小量噴霧器汙染之相關因素
書刊名:榮總護理
作者:諶欣瑜陳瑛瑛
作者(外文):Chen, Shin-yuChen, Yin-yin
出版日期:2018
卷期:35:4
頁次:頁409-418
主題關鍵詞:汙染小量噴霧器相關因素ContaminationSmall-volume nebulizerCorrelation factor
原始連結:連回原系統網址new window
相關次數:
  • 被引用次數被引用次數:期刊(0) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:0
  • 共同引用共同引用:1
  • 點閱點閱:1
手術後病人常使用噴霧治療來促進肺部擴張,但噴霧器可能因外源性途徑造成汙染,增加病人呼吸道菌種移生(colonization)或感染的風險,故落實噴霧治療之臨床照護對病人安全而言相當重要。本研究目的在探討導致噴霧器受細菌汙染相關因素,以減少病人因噴霧器汙染增加呼吸道菌種移生或感染之風險。採前瞻性追蹤觀察研究法,以2014年7月至2015年2月某醫學中心外科病房術後病人為對象,於病人接受噴霧治療前24小時內作口咽採檢和噴霧器使用後之檢驗,並實地訪查噴霧器清潔維護狀況,比較噴霧器汙染組與未汙染組之相關因素。共收案210位,74位(35.2%)曾發生噴霧器污染;影響噴霧器污染之顯著因素,經單變項分析有噴霧治療前口咽菌種移生和噴霧治療天數較長(7天)(p< .05);再經多變項分析發現,每增加一天噴霧治療則噴霧器汙染風險增加14% (p= .004)。建議醫護人員應每日評估病人是否有噴霧治療之適應症,若無適應症時應儘早停止治療醫囑,減少噴霧治療天數,以杜絕噴霧器污染之風險。
Aerosol therapy is widely used to induce expectorant action in patients after surgery. However, small-volume nebulizers can be contaminated through the exogenous route, increasing the risk of respiratory tract colonization or infection. Aerosol therapy care must be implemented in the clinic. This study aimed to examine the correlation factors of nebulizers for contamination and to reduce the risk of respiratory tract colonization or infection. This prospective study was conducted in the surgical ward of a medical center. Patients who underwent aerosol therapy after surgery between July 2014 and February 2015 were included. Oropharyngeal cultures were taken within 24 hours before patients undertook aerosol treatment, and nebulizer cultures were taken after the patients had used the nebulizers. Data on patients' practices of cleaning and maintaining nebulizers were collected to investigate the correlation factors of nebulizers for contamination. In total, 210 subjects were enrolled, among whom 74 (35.2%) experienced nebulizer contamination. Univariable analysis identified oral colonization and patients who underwent longer periods (e.g., >7 days) of aerosol therapy as two statistically significant correlation factors (p < .05). Multivariable analysis of correlation factors revealed that the number of days of aerosol therapy had a significant effect on nebulizer contamination. Each additional day of aerosol therapy increased the contamination rate of nebulizers by 14% (p = .004). We recommend that nurse educate patients before offering them aerosol therapy to improve daily posttherapy nebulizer cleaning compliance. In addition, doctors and nurses should evaluate patients daily, and if aerosol therapy is no longer appears necessary, discontinue it to reduce the days of aerosol therapy and contamination risks.
期刊論文
1.林明鋒、彭雅翎、陳敏慧、葉惠玟、黃美鑾(20071000)。噴霧治療後小量噴霧器細菌污染情形之研究。感染控制雜誌,17(5),287-298。  延伸查詢new window
2.戴佳惠、林念璁、彭台珠、李茹萍(20110300)。Cleaning Small-Volume Nebulizers: The Efficacy of Different Reagents and Application Methods。The Journal of Nursing Research,19(1),61-67。new window  new window
3.Alcon, A.、Fabregas, N.、Torres, A.(2005)。Pathophysiology of pneumonia。Clinics in Chest Medicine,26(1),39-46。  new window
4.Baravalle-Einaudi, M.、Dufeu, N.、Dupont, C.、Vecellio, L.、Delaisi, B.、Carsin, A.、Dubus, J. C.(2017)。Vibrating-mesh nebulizer maintenance by CF patients: Results from a French survey。Pulmonary Pharmacology & Therapeutics,44,57-60。  new window
5.Blau, H.、Mussaffi, H.、Zahav, M. M.、Prais, D.、Livne, M.、Czitron, B. M.、Cohen H. A.(2006)。Microbial contamination of nebulizers in the home treatment of cystic fibrosis。Child Care Health and Development,33(4),491-495。  new window
6.Botman, M. J.、de Krieger, R. A.(1987)。Contamination of small-volume medication nebulizers and its as sociation with oropharyngeal colonization。Journal of Hospital Infection,10,204-208。  new window
7.Brzezinski, L. X.、Riedi, C. A.、Kussek, P.、Souza, H. H.、Rosário, N.(2011)。Nebulizers in cystic fibrosis: A source of bacterial contamination in cystic fibrosis patients?。Journal Brasileiro de Pneumologia,37(3),341-347。  new window
8.Cohen, H. A.、Kahan, E.、Cohen, Z.、Sarrell, M.、Beni, S.、Grosman, Z.、Ashkenazi, S.(2006)。Microbial colonization of nebulizers used by asthmatic children。Pediatrics International,48(5),454-458。  new window
9.Denton, M.、Rajgopal, A.、Mooney, L.、Qureshi, A.、Kerr, K. G.、Keer, V.、Conway, S. P.(2003)。Stenotrophomonas maltophilia contamination of nebulizers used to deliver aerosolized therapy to inpatients with cystic fibrosis。Journal of Hospital Infection,55(3),180-183。  new window
10.Ehrmann, S.、Roche-Campo, F.、Bodet-Contentin, L.、Razazi, K.、Dugernier, J.、Trenado-Alvarez, J.、Brochard, L.(2016)。Aerosol therapy in intensive and intermediate care units: Prospective observation of 2808 critically ill patients。Intensive Care Medicine,42(2),192-201。  new window
11.Hohenwarter, K.、Prammer, W.、Aichinger, W.、Reychler, G.(2016)。An evaluation of different steam disinfection protocols for cystic fibrosis nebulizers。Journal of Cystic Fibrosis,15(1),78-84。  new window
12.Jadhav, S.、Sahasrabudhe, T.、Kalley, V.、Gandham, N.(2013)。The microbial colonization profile of respiratory devices and the significance of the role of disinfection: A blinded study。Journal of Clinical and Diagnostic Research,7(6),1021-1026。  new window
13.Johanson, W. G.、Pierce, A. K.、Sanford, J. P.、Thomas, G. D.(1972)。Nosocomial respiratory infections with gram-negative bacilli: The significance of colonization of the respiratory tract。Annals of Internal Medicine,77(5),701-706。  new window
14.Lester, M. K.、Flume, P. A.、Gray, S. L.、Anderson, D.、Bowman, C. M.(2004)。Nebulizer Use and Maintenance by Cystic Fibrosis Patients: A Survey Study。Respiratory Care,49(12),1504-1508。  new window
15.Maldonado, G.、Greenland, S.(1993)。Simulation study of confounder selection strategies。American journal of epidemiology,138(11),923-936。  new window
16.Peckham, D.、Williams, K.、Wynne, S.、Denton, M.、Pollard, K.、Barton, R.(2016)。Fungal contamination of nebuliser devices used by people with cystic fibrosis。Journal of Cystic Fibrosis,15(1),74-77。  new window
17.Roberts, F. J.、Cockcroft, W. H.、Johnson, H. E.、Fishwick, T.(1973)。The infection hazard of contaminated nebulizers。Canadian Medical Association Journal,108(1),53-56。  new window
18.Rodríguez González-Moro, J. M.、Andrade Vivero, G.、de Miguel Díez, J.、López Martín, S.、Sánchez, C.、Izquierdo Alonso, J. L.、de Lucas Ramos, P.(2004)。Bacterial colonization and home mechanical ventilator: Prevalence and risk factors。Archivos de Bronconeumología,40(9),392-396。  new window
19.Saiman, L.、Siegel, J. D.、LiPuma, J. J.、Brown, R. F.、Bryson, E. A.、Chambers, M. J.、Weber, D. J.(2014)。Infection prevention and control guideline for cystic fibrosis: 2013 update。Infection Control & Hospital Epidemiology,35(S1),S1-S67。  new window
20.Zuana, A. D.、Garcia, D. D. O.、Juliani, R. C. T. P.、Silva Filho, L. V. R. F.(2014)。Effect that an educational program for cystic fibrosis patients and caregivers has on the contamination of home nebulizers。Jornal Brasileiro de Pneumologia,40(2),119-127。  new window
21.Monforte, V.、Roman, A.、Gavalda, J.、Bravo, C.、Rodriguez, V.、Ferrer, A.、Morell, F.(2005)。Contamination of the nebulization systems used in the prophylaxis with amphotericin B nebulized in lung transplantation。Transplantation Proceedings,37(9),4056-4058。  new window
22.Tablan, Ofelia C.、Anderson, Larry J.、Besser, Richard、Bridges, Carolyn、Hajjeh, Rana(20040326)。Guidelines for preventing health-care-associated pneumonia, 2003: Recommendations of CDC and the healthcare infection control practices advisory committee。Morbidity & Mortality Weekly Recommendations & Reports,53(RR-3),1-36。  new window
圖書
1.吳英黛(2012)。呼吸循環系統物理治療--基礎實務。臺北:金名。  延伸查詢new window
2.吳許得、江復進、林世斌、陳立功、陳雪芬、關政平(2002)。普通微生物學。台中市:華格那。  延伸查詢new window
3.Mayhall, C. G.(2012)。Hospital epidemiology and infection control。Philadelphia, PA:Lippincott Wilkins。  new window
 
 
 
 
第一頁 上一頁 下一頁 最後一頁 top
QR Code
QRCODE