가정간호학회지 (Journal of Korean Academic Society of Home Health Care Nursing)

한국가정간호학회 (Korean Academic Society of Home Health Care Nursing)
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가정용 인공호흡기 적용 신경근육계 희귀난치성 질환자 가족 간호제공자의 기관내 흡인 수행과 폐렴 발생과의 관계

Pneumonia Incidence Varies by Tracheal Suction Procedures among Caregivers of Patients with Home Mechanical Ventilators

  • 투고 : 2016.04.15
  • 심사 : 2016.05.31
  • 발행 : 2016.06.30
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초록

Purpose: This study aimed to survey caregivers of patients with Neuromuscular Rare and Incurable Disease (NRID) using invasive home mechanical ventilator (HMV), in order to compare the incident rate of pneumonia by tracheal suction procedures used. Method: Participants were 99 family caregivers of NRID patients using HMV. Participants were given a questionnaire consisting of 12 demographic items, 10 items about disease and HMV related characteristics, 11 items about tracheal suction procedures, and 2 items about the incidence of pneumonia. Data were analyzed using chi-square tests and t-tests. Results: The items that predicted the incidence of pneumonia were "change of irrigation saline every suction" (p=.047), "use of aseptic catheter every suction" (p=.004), and "instillation of normal saline before suction" (p=.027). In addition, these items were 47.4%, 51.4%, and 38.8% respectively. Conclusion: Family members caring for NRID patients with invasive HMV should be educated about tracheal suction, especially the necessity of changing irrigation saline after every suction, using the aseptic catheter for every suction, and instillation of normal saline before suction. Medical personnel such as home care nurses should periodically check tracheal suction procedures, and re-educate family caregivers when necessary.

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참고문헌

  1. American Association for Respiratory Care. (2010). AARC Clinical Practice Guidelines. Endotracheal suctioning of mechanically ventilated patients with artificial airways. Respirory Care, 55(6), 758-764.
  2. Araujo da Silva, A. R., Vieira de Souza, C., Viana Guimaraes, M. E., Sargentelli, G., & Ribeiro Gomes, M. Z. (2012). Incidence rates of healthcare-associated infection in a pediatric home healthcare service. Infection Control of Hospital Epidemiology, 33(8), 845-848. https://doi.org/10.1086/666627
  3. Ayhan, H., Tastan, S., Iyigun, E., Akamca, Y., Arikan, E., & Sevim, Z. (2015). Normal saline instillation before endotracheal suctioning: "what does the evidence say? what do the nurses think?": multimethod study. Journal of Critical Care, 30(4), 762-767. https://doi.org/10.1016/j.jcrc.2015.02.019
  4. Cha, K. S., & Park, H. R. (2011). Endotracheal colonization and ventilator-associated pneumonia in mechanically ventilated patients according to type of endotracheal suction system. Journal of Korean academy of nursing, 41(2), 175-181. https://doi.org/10.4040/jkan.2011.41.2.175
  5. Chenoweth, C. E., Washer, L. L., Obeyesekera, K., Friedman, C., Brewer, K., Fugitt, G. E., & Lark, R. (2007). Ventilator -associated pneumonia in the home care setting. Infection Control of Hospital Epidemiology, 28(8), 910-915. https://doi.org/10.1086/519179
  6. Guay, D. R. (2006). Guidelines for the management of adults with health care-associated pneumonia: implications for nursing facility residents. The Consult Pharmacist. 21(9), 719-725. https://doi.org/10.4140/TCP.n.2006.719
  7. Han, J., & Liu, Y. (2010). Effect of ventilator circuit changes on ventilator-associated pneumonia: a systematic review and meta-analysis. Respiratory Care, 55(4), 467-474.
  8. Hwang, M. S., & Chang, S. J. (2013). Self-care education experience, self-care performance, and home care service needs of patients with rare and incurable diseases who use a home ventilator. The Journal of korean academic society of home care nursing, 20(1), 5-15.
  9. Hwang, M. S., Lee, M. K., & Song, J. R. (2014). The factors affecting burdens and quality of life of the family caregivers of patient with rare and incurable diseases using home ventilators. The Korean journal of Adult Nursing, 26(2), 191-202. https://doi.org/10.7475/kjan.2014.26.2.191
  10. Imaiso, J., & Yamauchi, T. (2009). Caregiver suctioning education for Japanese patients with an invasive home ventilator. Nursing Health Science, 11(4), 422-429. https://doi.org/10.1111/j.1442-2018.2009.00469.x
  11. Jo, H. I., Lee, Y. H., Ham, O. G., & Lim, J. Y. (2008). The impact of different endotracheal suction methods on respiratory function : normal saline with chest vibration vs normal saline with expectorant mixture. The Korean journal of Adult Nursing, 20(2), 24-33.
  12. Kang, S. W., Park, J. H., Ryoo, H. H., Kang, Y. S., & Moon, J. H. (2004). Non-invasive mechanical ventilator care for the patients with advanced neuromuscular disease. Annals of Rehabilitation Medicine, 28(1), 71-77.
  13. Kim, H. Y., Park, K. H., Koh, S. H., Lee, S. C., Nam, J. H., Kim, J. H., & Kim, S H. (2007). Korean version of amyotrophic lateral sclerosis functional rating scale-revised: a pilot study on the reliability and validity. Journal of the Korean Neurological Association. 25(2), 149-154.
  14. Kim, K. S., & Lee, S. M. (2010). Effects of ventilator-associated pneumonia (VAP) control education on ICU nurses' infection control performance and incidence of pneumonia. Journal of Korean critical care nursing, 3(3), 13-22.
  15. King, A. C. (2012). Long-term home mechanical ventilation in the United States. Respirtory Care. 57(6), 921-990. https://doi.org/10.4187/respcare.01741
  16. Lee, E. S., Kim, S. H., & Kim, J. S. (2004). Effect of closed endotracheal suction system on oxygen saturation, ventilator -associated pneumonia, and nursing efficacy. Journal of Korean Academy of Nursing, 34(7), 1315-1325. https://doi.org/10.4040/jkan.2004.34.7.1315
  17. Lee, M. O., & Lee. Y. J. (2003). Proper time of the sterile tracheal suction catheter change based on nursing clinic. The Journal of Korean Biological Nursing Science, 5(1), 45-54.
  18. Lim, Y. H., & Yu, K. S. (1998). A study on the contamination of solution with suction used in tracheostomy patients. Jouranl of Korean Health Nursing Academic Society, 12(6), 185-200.
  19. Oh, H. S. (2003). Meta-analysis on the effectiveness of interventions applies to preventing endotracheal suction-induced hypoxemia. Journal of Korean Academy of Nursing, 33(1), 42-50. https://doi.org/10.4040/jkan.2003.33.1.42
  20. Park, S. Y., & Lee, H. B. (2014). Prevention and management of ventilator-associated pneumonia. Korean Journal of Medicine, 86(5), 537-545. https://doi.org/10.3904/kjm.2014.86.5.537
  21. Simonds, A. K. (2006). Recent advances in respiratory care for neuromuscular disease. Chest, 130(6), 1879-1886. https://doi.org/10.1378/chest.130.6.1879
  22. Song., K. A., Park, H. S., Hong, Y. H., Lee, K. Y., Jeong. S. G., et al. (2014). Fundamentals of nursing interventions skills. Seoul: Soomoonsa.
  23. Song, K. J., Yoo, J. S., Kwon, E. O., Jung, E. J., Shin, H. J., Park, O. H., Ok, S. O., Yu, M., Yun, S. H., Lee, B. K., Choi, J. A., Hwang, J. H., & Oh, H. S. (2001). The effects of standardized suction and ventilator management protocol on ventilator associated pneumonia in the intensive care unit. Journal of Korean Society of Quality Assurance in Health Care, 8(2), 44-55.
  24. Song, Y. E. (2003). Nursing needs of the patient on home ventilator. Unpublished master's thesis, Ewha Woman University, Seoul.
  25. Yang E. J. (2013). Performance of endotracheal suction in mechanically ventilated patients in nurses working at intensive care units. Unpublished master's thesis, Kyung Hee University, Seoul.
  26. Yeom, H. K., Lee, S. S., Lee, H. P., & Choi, S. J. (2005). Essential of Mechanical Ventilation. Seoul: Koonja.
  27. Yoon, Y. M. (2014). Development and effect of a family caregiver self-efficacy enhancement program for the prevention pneumonia in stroke patients. Unpublished docter's thesis, Korea University, Seoul.