Abstract: Objective To analyze the risk factors of nosocomial infection in patients with trauma and nursing points. Methods the clinical data of 150 patients with traumatic infection treated in our hospital from December 2012 to December 2014 were retrospectively analyzed. The risk factors of nosocomial infection were discussed. Compared with the results without disturbance of consciousness and hospitalization in patients with shock, the incidence rate was significantly higher in the infection itself combined with disturbance of consciousness in diabetes and shock patients in hospital (P<0.05); the incidence rate was significantly higher than that of indwelling catheter time and hospitalization time of patients with short hospital infection and prolong the indwelling catheter time and hospitalization time (P<0.05). Conclusion the patients with consciousness disorder, shock, indwelling catheter and long hospital stay are the high risk factors of nosocomial infection, and should pay great attention to it and take comprehensive nursing intervention measures to promote rapid rehabilitation.
Key words: nosocomial infection; nursing points; risk factors; trauma.
0, introduction.
Compared with other diseases, fracture, combined injury or brain injury is more likely to result in severe trauma, some patients because of serious illness, need to prolong treatment and hospitalization time, which increased the risk of nosocomial infections, will also affect the rapid recovery of patients to a certain extent, will not only increase the suffering of patients, will the increase of the pressure of family and society [l]. the retrospective analysis of the clinical data of 150 patients with trauma in our hospital infection, to analysis the risk factors of nosocomial infection and to investigate the nursing program, the following report:
1, data and methods.
1.1 general information. Methods the clinical data of 150 patients with traumatic infection in our hospital from December 2012 to December 2014 were retrospectively analyzed. Among them, there were a total of 70 male patients and a female patient with a mean age of 25~65 years (range, 42.8 to 6.5), with a mean age of years. There were 50 cases of severe craniocerebral injury, 10 cases of systemic blast injury, and of the femoral comminuted fractures in the middle of the year, and 30 cases of multiple fractures of the body with pneumothorax in 60 cases. The average length of hospital stay was 565 (D. = 10.1)
1.2 method. The clinical data of all patients were retrospectively analyzed to observe the state of consciousness and record the hospitalization time, based on the risk factors of infection in trauma patients during hospitalization in the hospital were analyzed, summarize the nursing strategy of the.
1.3 statistical processing. The application of statistical software SPSS22.0 analysis of all the data, the count data obtained by percentage (%) were expressed, compared to before the test, if P<0.05, said the difference was significant, with statistical significance.
2, results.
The incidence rate was significantly higher than that of the consciousness and shock of infection in patients with disorders of consciousness during hospitalization itself with diabetes and shock patients in hospital, significant difference (P<0.05); the incidence rate was significantly higher than that of indwelling catheter time and hospitalization time of patients with short hospital infection and prolong the indwelling catheter time and hospitalization time (P<005), specific see table L.
3, discussion.
The study results, consciousness disorders, shock, indwelling catheter and long hospital stay were risk factors of nosocomial infection, the risk of danger, mainly take the following nursing intervention measures: (1) basic disease nursing intervention measures: if the trauma patients accompanied by diabetes, adversely affect the blood sugar will the phagocytic function of granulocytes and lymphocytes, reduce the patient's resistance. When the patients had stable disease treatment, nursing staff must fully understand the specific situation, in the treatment of trauma at the same time on the basis of the disease but also to active treatment of [2]. (2): consciousness of nursing intervention in patients with severe trauma disease, are susceptible to disturbance of consciousness, and consciousness to some extent effect of cough reflex, which continues to weaken or even disappear, increase the discharge in the lower respiratory tract secretions difficulty, cause hypostatic pneumonia; some patients because of respiratory tract obstruction need timely treatment to avoid tracheotomy, without humidification or filtered air directly into the lungs of patients with enhanced respiratory irritation; nursing staff for patients with smoking in the process of sputum, is likely to cause irritation to the airway, causing respiratory tract mucosal barrier damage. These conditions can lead to respiratory tract infection. In view of tracheotomy patients need to do a good job of incision protection measures, according to the doctor's time to change dressing, reasonable control of the amount of oxygen inhalation, airway humidification. The nursing staff should regularly ventilate the room and keep the air circulation. After the patients with disturbance of consciousness, the activities will be restricted to a certain degree, the nursing staff must strengthen the nursing intervention for patients with skin, use hot towel to wipe the body for the patient, do local massage, for patients, timing turn back, often make the bed, keep the bed dry and clean health, [3]. (3) shock nursing intervention: Patients after trauma, if the disease is severe because of excessive bleeding or pain will happen shock, once the symptoms of shock, the intestinal mechanical barrier may be destroyed, the immune system will have serious damage, even lead to dysfunction, when exogenous bacterial invasion is very easy to direct attached to the intestinal wall, cause infection. First of all, the nursing staff should strictly follow the doctor's advice to the patient to carry out fluid replacement, expand its blood volume, together with the doctor for the patient to complete debridement and hemostasis, to monitor their vital signs. If the pain is severe, according to the condition and physical condition and give the appropriate amount of analgesic drugs, if the patient consciousness is awake, the nursing staff to the psychological nursing intervention of [4]. (4): indwelling catheter nursing intervention in the nursing operation when some nursing personnel must strictly aseptic operation, replacement of regular urine bag on, urethral mouth to do disinfection treatment of bladder flushing, the catheter will change regularly. The timing of open catheter, bladder function recovery of patients timely, early catheter removal; (5) the hospitalization time: during hospitalization, nursing staff must create a safe and comfortable hospital environment, keep the ward clean, wipe the goods and equipment related to the timing of the ward, strictly limit the visiting time and number of visits the patients were given support and encouragement, to explain the matters needing attention in daily life and disease related knowledge, give the cure of confidence and courage, to improve its autonomy with the treatment and care consciousness, improve their treatment compliance, promote the early recovery of health yan. (6) wound nursing interventions: after the patient is in hospital, the nursing staff should observe the wound closely and keep the local sanitation clean.
4, experience.
Under the influence of the immune system and the related factors such as stress stimulation, trauma patients are prone to nosocomial infection, which is not only conducive to the early recovery of patients, but also lead to medical disputes. There are many factors leading to nosocomial infection in patients with trauma, and the most common risk factors are consciousness disturbance, shock, indwelling catheter and long hospital stay. Therefore, at the same time for diabetes, patients with disturbance of consciousness or shock, we must do a good job monitoring measures, and actively improve the relevant examination, at the same time on the basis of the disease should be timely and effective treatment; if patients need indwelling catheter, catheter must give the corresponding nursing intervention, good wound treatment. In a word, we should pay more attention to the phenomenon of clinical infection of trauma patients in the hospital, and take the humanized nursing intervention system, shorten the hospitalization time, to control the incidence of nosocomial infection, promote early recovery of patients [6].
Reference?
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[2] green wind. Investigation and preventive nursing of nosocomial infection in patients with cerebral hemorrhage. Gansu medicine, 2013,32 (2): 150-152.
[3] Chen Aihong. Analysis of risk factors and nursing strategy of nosocomial infection in trauma patients. The world's latest medical information Abstracts (continuous electronic journal), 2015 (27): 230-230.
[4] Wang Jianzhu, Song Limei, et al.. Analysis of the causes of nosocomial infection in patients with cerebral hemorrhage and nursing intervention. Yanbian medical journal, 2014 (31): 140-141142.