A study of the risk factors of ICU acquired pneumonia and the effect of the closed suctioning method in reducing the risk of ICU-acquired pneumonia

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A study of the risk factors of ICU acquired pneumonia and the effect of the closed suctioning method in reducing the risk of ICU-acquired pneumonia

 

Author: Tse, Kai-wing
Title: A study of the risk factors of ICU acquired pneumonia and the effect of the closed suctioning method in reducing the risk of ICU-acquired pneumonia
Degree: M.Sc.
Year: 2003
Subject: Hong Kong Polytechnic University -- Dissertations
Nosocomial infections
Intensive care units
Pneumonia
Liposuction
Department: School of Nursing
Pages: 121 leaves : ill. (some col.) ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b1717734
URI: http://theses.lib.polyu.edu.hk/handle/200/4853
Abstract: Pneumonia is common in ICU patients, and the suctioning technique is believed to have an association with the infection rate. With recent technological advances, closed suctioning system and its method have been trailed with the aim of reducing the rate of pneumonia. This study seeks to investigate the effect of the closed suctioning method on the risk of nosocomial pneumonia and to identify the other risk factors of pneumonia in critically ill patients. A retrospective cohort study in an application of closed suctioning method and traditional suctioning method was carried out in an intensive care unit from January 2000 to December 2001. About 500 critically ill patients in critical care units were selected to participate in the control and study groups separately in the study and all the data were subject to both univariate analysis (Chi-square test, Fisher's exact test and independent t-test) and multivariate analysis (logistic regression). Risk factors for pneumonia identified by univariate analysis included units of admission, comorbid conditions, respiratory insufficiency, level of consciousness, use of mechanical ventilation, age, sex, uses of antibiotics, used of closed suctioning method, days on endotracheal tube and tracheotomy tube. In the multivariate analysis, level of consciousness, use of mechanical ventilation, uses of antibiotics, use of closed suctioning method, days on the endotraheal tube and tracheotomy tube were found to be independent predictors of nosocomial pneumonia. In the result, 149 (29.8%) patients were classified as having pneumonia by study of diagnostic criteria. Number of days on tracheostomy and endotracheal tube were significant risk factors for pneumonia. Thus the longer the patient had an endotracheal tube or tracheostomy tube in situ, the greater the risk of pneumonia for that the patient. But they are not clinical significances as 'Odd ratio' of them are 1.179 and 1.024 separately. In addition, 51 out of 250 (20.4%) patients with using closed suctioning system were diagnosed as pneumonia. And 98 out of 250 (39.2%) patients using the open suctioning method had developed pneumonia. There was a significant difference in the risk of pneumonia between patients using the closed suctioning method (CSM) and those using a traditional open suctioning method with using a disposable single-use suction catheter, Thus the closed suctioning method can be used as infection control nursing skill and it is highly recommended for the critical care patient, especially the patients with immunological compromised disease or patients receiving immunosuppressive drugs, or the patients at high risk of pneumonia.

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