A Study On The Operation Experience Of ICU Device Operator’s "Three Tube" From The Phenomenological Perspective

ObjectiveThrough in-depth interviews with the device operators of ICU,this study aims to seek and understand the real working experience of the "three-tube" infection prevention and control experience to influence the compliance of the relevant infection prevention and control measures,and provide reference for the implementation of relevant measures and the formulation of policies.MethodsAccording to the purpose sampling method,a semi-structured and face-to-face interview with the device operators working in a third-class hospital,and a total of 18 subjects were determined subject to data saturation.Data collection and analysis process are conducted simultaneously.The recording content will be converted into text data word,word by sentence within 24 hours after the interview,numbered the interview record of each interviewee and established documents,and used Colaizzi 7analysis to refine the topic.ResultsThis study summarized five topics from ventilator-related pneumonia(VAP),catheter-related urinary tract infection(CAUTI),central catheter-related blood flow infection(CLABSI),hand hygiene,and infection prevention and control.1.Ventilator-associated pneumonia(VAP)(1)Obstructions of compliance of VAP prevention and control measures: limited bedside elevation,inadequate oral care in patients with endotracheal intubation,discontinuous airbag management,complicated diagnosis of VAP,downmigration of oral bacteria,VAP prevention need for bundling strategy,and the application of sedative drugs.(2)Facilitating factors of compliance of VAP prevention and control measures:specially pour condensate,apply closed sputum suction tube,improve oral condition,guidance and supervision of respiratory therapists,and assistance of nursing workers.2.Catheter-associated urinary tract infection(CAUTI)(1)Obstrucfactors of compliance of CAUTI prevention and control measures:insufficient attention to urinary tract infection and simplified operation process during emergency rescue.(2)Promotion factors of compliance of CAUTI prevention and control measures:systematic learning,computer nurses on time and pay attention to patient prognosis.3.Central line associated-bloodstream infection(CLABSI)(1)Obstructive factors of compliance of CLABSI prevention and control measures: sterile treatment napkins are ignored,insufficient experience,and anxious to change drugs are easy to pollute consumables,and puncture is difficult to ignore sterile operation.(2)Promotion factors of the compliance of CLABSI prevention and control measures: attach importance to the aseptic requirements of puncture and tube placement,leadership supervision,and rigorous process of dressing replacement.4.Hand hygiene(1)Compliance obstruction factors of hand hygiene: hand hygiene under intact skin barrier is easy to be ignored,low compliance of hand hygiene,incomplete supervision mechanism,repeated contact with patients,dependence on disposable gloves,emergency(2)Hand hygiene compliance facilitation factors: self-protection,hand elimination convenience,prevention of cross-infection5.Infection prevention and control(1)Infection prevention and control measures: lack of supervision of night shift,sensory control team is a mere formality,heavy workload,pursuit of trouble,paying attention to the treatment of patients ’ disease,incomplete coverage of invasive catheter terminal specimens,insufficient consciousness,and complex personnel involved(2)Compliance promotion factors of infection prevention and control measures:continuous supervision(urge special personnel,supervise medical care,supervise key personnel),attach attention to sensory control education,establish reward and punishment system,improve reporting system,control the proportion of patients,and strict training.ConclusionAccording to the results of the interview,the prevention and control compliance obstacles of ventilator-related pneumonia,catheter-related urinary tract infection,and central catheter-related blood flow infection are mainly concentrated in management and consciousness In the specific details of these three aspects,to reduce the incidence of VAP,CAUTI,CLABSI,improve the compliance of the "three-tube" infection prevention and control measures of ICU medical personnel should mainly solve these three aspects,actively encourage the implementation of promoting factors,and take relevant response measures according to the obstruction factors.