Document Type : Research articles
Authors
1
demonstrator Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University
2
Professor Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University
3
Professor Critical Care Medicine, Faculty of Medicine, Alexandria University
4
Lecturer Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University
Abstract
Background: Critically ill patients have many diagnoses as stroke that may
produce a lot of complications. One of these complications is a post-stroke
pulmonary infection (PSPI). Post-stroke pulmonary infection that occurs within
seven days of stroke onset. Many risk factors may be responsible for the occurrence
of PSPI. therefore, the health team must perform an early assessment to identify this
factor and prevent its occurrence. Objective: To Identify the risk factors of poststroke
pulmonary infection in critically ill patients. Settings: The study was carried
out in the intensive care units (ICUs) at Alexandria Main University Hospital,
Egypt. Subjects: newly admitted critically ill adult patients (70) with recent
cerebrovascular stroke were included in the study Patients who were excluded:
have pneumonia before the stroke, Active infection within 2 weeks before admission
or prophylactic antibacterial therapy, dysphagia before the stroke, Severe hepatic,
renal diseases, cancer received immunosuppressant treatment, and History of
stroke. Tools: Two tools were utilized for data collection in this study. Tool one:
“Risk factors of post-stroke pulmonary infection assessment”, Tool two: A2DS2
tool A (age), A (Atrial fibrillation), D (dysphagia), S (Sex), S (Stroke Severity).
Results: The study showed that A. Patients-related risk factors such as oral disease,
disturbed level of consciousness, dependent self-position, and decreased albumin
level significantly contributed to the PSPI (p <0.001, 0.023, 0.010, 0.001
respectively). B. Nurses-related risk factors include not Performing hand hygiene
with the right technique, not following sterile technique during tracheal suction,
instillation of saline during tracheal suction, not performing oral hygiene to
patients with an antiseptic solution, not Monitoring cuff pressure, not performing
percussion, did not perform coughing exercise were significantly contributed to the
PSPI (p = 0.011, 0.007, 0.016, 0.048, <0.001, 0.005 respectively). Conclusion: the
risk factors that increase the incidence of PSPI were dysphagia, severity of stroke,
oral disease, disturbed level of consciousness, and immobility. Recommendations:
Critical care nurses should conduct comprehensive assessments for risk factors
such as swallowing tests, stroke severity, oral disease, and level of consciousness
for patients who are suffering from acute stroke.
Keywords
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