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
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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.
Abstract
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.
참고문헌 (27)
- American Association for Respiratory Care, "AARC Clinical Practice Guidelines. Endotracheal suctioning of mechanically ventilated patients with artificial airways", Respirory Care, 55(6), pp.758~764 (2010)
- Araujo da Silva, A. R, "Incidence rates of healthcare-associated infection in a pediatric home healthcare service", Infection Control of Hospital Epidemiology, 33(8), pp.845~848 (2012)
- Ayhan, H, "Normal saline instillation before endotracheal suctioning : "what does the evidence say? what do the nurses think?" : multimethod study", Journal of Critical Care, 30(4), pp.762~767 (2015)
- 차경숙, "기관 흡인술 유형에 따른 인공호흡기 적용 환자의 기관 내 균집락화와 폐렴 발생률", Journal of Korean Academy of Nursing, 41(2), pp.175~181 (2011), 한국간호과학회
- Chenoweth, C. E, "Ventilator-associated pneumonia in the home care setting", Infection Control of Hospital Epidemiology, 28(8), pp.910~915 (2007)
- Guay, D. R, "Guidelines for the management of adults with health care-associated pneumonia : implications for nursing facility residents", The Consult Pharmacist, 21(9), pp.719~725 (2006)
- Han, J, "Effect of ventilator circuit changes on ventilator-associated pneumonia : a systematic review and meta-analysis", Respiratory Care, 55(4), pp.467~474 (2010)
- 황문숙, "가정형 인공호흡기를 적용하고 있는 희귀, 난치성 질환자의 자가관리 교육 경험과 수행정도, 가정간호 요구도", 가정간호학회지, 20(1), pp.5~15 (2013), 한국가정간호학회
- 황문숙, "가정용 인공호흡기를 적용한 희귀·난치성질환자를 돌보는가족간호자의 부담감과 삶의 질 영향요인", 성인간호학회지, 26(2), pp.191~202 (2014), 성인간호학회[DOI]
- Imaiso, J, "Caregiver suctioning education for Japanese patients with an invasive home ventilator", Nursing Health Science, 11(4), pp.422~429 (2009)
- 조효임, "기관내 흡인방법에 따른 호흡기능의 차이", 성인간호학회지, 20(2), pp.24~33 (2008), 성인간호학회
- 강성웅, "말기 신경근육계 환자에서 비침습적 호흡기 관리", Annals of Rehabilitation Medicine, 28(1), pp.71~77 (2004), 대한재활의학회
- 김현영, "한글판 Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised : 신뢰도와 타당도에 관한 예비연구", 대한신경과학회지, 25(2), pp.149~154 (2007), 대한신경과학회
- Kim, K. S, "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), pp.13~22 (2010)
- King, A. C, "Long-term home mechanical ventilation in the United States", Respirtory Care, 57(6), pp.921~990 (2012)
- 이은숙, "폐쇄형 흡인술이 인공호흡기 환자의 산소포화도, 인공호흡기 관련 폐렴 및 흡인간호 효율성에 미치는 영향", Journal of Korean Academy of Nursing, 34(7), pp.1315~1325 (2004), 한국간호과학회
- Lee, M. O, "Proper time of the sterile tracheal suction catheter change based on nursing clinic", The Journal of Korean Biological Nursing Science, 5(1), pp.45~54 (2003)
- Lim, Y. H, "A study on the contamination of solution with suction used in tracheostomy patients", Jouranl of Korean Health Nursing Academic Society, 12(6), pp.185~200 (1998)
- 오현수, "기관내 흡인으로 인한 저산소증 예방을 위한 중재 효과에 대한 메타분석", Journal of Korean Academy of Nursing, 33(1), pp.42~50 (2003), 한국간호과학회
- 박승용, "인공호흡기 연관 폐렴의 예방과 치료", 대한내과학회지, 86(5), pp.537~545 (2014), 대한내과학회[DOI]
- Simonds, A. K, "Recent advances in respiratory care for neuromuscular disease", Chest, 130(6), pp.1879~1886 (2006)
- Song., K. A, "Fundamentals of nursing interventions skills" (2014), Soomoonsa
- Song, K. J, "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), pp.44~55 (2001)
- Song, Y. E, "Nursing needs of the patient on homeventilator", master, pp.2003
- Yang E. J, "Performance of endotracheal suction in mechanically ventilated patients in nurses working at intensive care units", master, pp.2013
- Yeom, H. K, "Essential of Mechanical Ventilation" (2005), Koonja
- Yoon, Y. M, "Development and effect of a family caregiver self-efficacy enhancement program for the prevention pneumonia in stroke patients", docter’s, pp.2014