ICU护士成人人工气道管理能力现状及影响因素分析

doi:10.16138/j.1673-6087.2026.02.08

摘要/Abstract

摘要：

目的：调查我国三级甲等（三甲）医院重症监护病房(intensive care unit, ICU)护士成人人工气道管理能力现状，并分析其影响因素，为后期开展培训提供参考。方法：采用便利抽样法，于2024年4月—6月选取上海市、哈尔滨市2所三级甲等医院的366名ICU护士为调查对象，回收有效问卷309份。应用一般资料调查表、ICU护士成人人工气道管理能力问卷进行调查，采用多元线性回归分析ICU护士成人人工气道管理能力的影响因素。结果：309名ICU护士成人人工气道管理能力总分为（275.89±33.26）分，条目均分为（4.38±0.53）分。其中人工气道吸痰能力总分为（87.60±9.85）分，条目均分为（4.38±0.49）分；人工气道湿化能力总分为（48.40±6.37）分，条目均分为（4.40±0.58）分；人工气道气囊管理能力总分为（64.54±9.43）分，条目均分为（4.30±0.63）分；人工气道拔管护理能力总分为（30.60±4.61）分，条目均分为（4.37±0.66）分；人工气道并发症预防能力总分为（44.72±5.78）分，条目均分为（4.70±0.58）分。线性回归结果显示，科室、护理工作年限、ICU工作年限为ICU护士成人人工气道管理能力的影响因素（P<0.05）。结论：三甲医院ICU护士成人人工气道管理能力处于中等偏上水平，未来应为不同科室和工作年限的护士开展针对性培训，尤其是人工气道气囊管理能力的加强，以进一步提升ICU护士人工气道管理综合能力。

关键词: 重症监护病房, 人工气道, 管理, 影响因素

Abstract:

Objective To investigate the current status of adult artificial airway management competence of intensive care unit (ICU) nurses in tertiary grade-A hospitals in China, and to analyse its influencing factors, so as to provide a reference for future training. Methods A total of 366 ICU nurses from 2 tertiary grade-A hospitals in Shanghai and Harbin were surveyed via convenience sampling from April to June 2024, and 309 valid questionnaires were returned. A general information questionnaire and the ICU nurses' adult artificial airway management competence questionnaire were used for the survey. Multiple linear regression was used to analyse the factors influencing ICU nurses’ adult artificial airway management competence. Results The total score of adult artificial airway management competence of ICU nurses was (275.89 ±33.26) points with an average item score of (4.38±0.53) points. Among the dimensions, the score for artificial airway sputum suction ability was (87.60±9.85) points with an average item score of (4.38±0.49) points; artificial airway humidification competence was (48.40±6.37) points with an average item score of (4.40±0.58) points; artificial airway cuff management competence was (64.54±9.43) points with an average item score of (4.30±0.63) points; artificial airway extubation nursing competence was (30.60±4.61) points with an average item score of (4.37±0.66) points; and artificial airway complication prevention competence was (44.72±5.78) points with an average item score of (4.70±0.58) points. Linear regression analysis revealed that department, number of years working in nursing, and number of years working in the ICU were influencing factors for ICU nurses’ artificial airway management competence (P<0.05). Conclusions The adult artificial airway management competence of ICU nurses in tertiary grade-A hospitals is at an upper-intermediate level. In the future, targeted training should be carried out for nurses in different departments and with different years of working experience, with special emphasis on enhancing artificial airway cuff management competence, so as to further improve the comprehensive ability of artificial airway management of ICU nurses.

Key words: intensive care unit, artificial airway, management, influencing factors

陈惠, 姚屹瑾, 钱珠萍, 张寅. ICU护士成人人工气道管理能力现状及影响因素分析[J]. 内科理论与实践, 2026, 21(02): 153-160.

CHEN Hui, YAO Yijin, QIAN Zhuping, ZHANG Yin. Analysis of the current situation and influencing factors of ICU nurses’ adult artificial airway management competence[J]. Journal of Internal Medicine Concepts & Practice, 2026, 21(02): 153-160.

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条目	条目均分（$\bar{x}±s$）	所在维度
1 cmH₂O=0.098 kPa。
得分排名前5位
条目10 我在置入吸痰管过程中不带负压	4.74±0.59	人工气道吸痰
条目14 吸痰过程中，我会密切观察患者的面色、呼吸、血氧饱和度、心率/律和血压	4.73±0.55	人工气道吸痰
条目15 患者进行密闭式吸痰后，我会及时使用灭菌注射用水或无菌0.9%氯化钠溶液充分冲洗管路	4.70±0.60	人工气道吸痰
条目31 我会及时清除呼吸机管路、积水杯中的冷凝水	4.68±0.64	人工气道湿化
条目18 我会根据产品说明书定期更换密闭式吸痰管，出现可见污染或套囊破损时立即更换	4.63±0.62	人工气道吸痰
得分排名后5位
条目4 我会至少每2 h通过肺部听诊等方式评估机械通气患者是否需要吸痰	3.64±1.15	人工气道吸痰
条目3 我遵循按需吸痰，仅在出现临床指征时进行人工气道内吸痰	3.90±1.10	人工气道吸痰
条目40 对于已知或疑似通过飞沫或气溶胶传播的呼吸道传染病患者,如果遇到高气道压力,我认为应　　　　该调整气管导管气囊压力比气道峰压高5 cmH₂O	4.07±0.94	人工气道气囊管理
条目35 我知道聚氨酯材料的人工气囊可以预防短期气管插管患者的呼吸机相关性肺炎	4.10±0.90	人工气道气囊管理
条目5 我认为开放式吸痰法和密闭式吸痰法均能有效清除人工气道分泌物	4.16±0.83	人工气道吸痰

项目	人数（n）	人工气道管理能力总分（$\bar{x}±s$）	t/F	P
性别			0.33	0.74
男性	47	274.40±34.77
女性	262	276.16±33.04
年龄（岁）			0.36	0.84
<26	66	276.05±30.72
26~30	98	273.70±28.88
31~35	81	275.42±42.26
36~40	44	280.84±27.95
＞40	20	277.10±32.77
科室			2.92	<0.05
综合ICU	178	280.39±31.68
急诊ICU	41	268.56±29.45
烧伤ICU	28	262.21±39.34
呼吸ICU	21	280.67±24.78
心脏ICU	36	273.78±32.76
神经ICU	5	247.60±72.65
护理工作年限（年）			0.33	0.86
≤5	107	275.41±28.64
6~10	105	273.76±35.59
11~15	55	279.56±38.52
16~20	27	276.44±33.98
＞20	15	279.73±27.30
ICU工作年限（年）			2.89	<0.05
≤5	149	270.38±33.78
6~10	84	280.90±30.19
11~15	50	276.68±38.80
16~20	16	294.13±16.43
＞20	10	282.80±25.56
学历			0.73	0.49
专科	74	272.14±33.17
本科	227	277.26±33.56
硕士及以上	8	271.75±24.43
职称			0.56	0.64
护士	68	274.38±31.76
护师	150	274.45±35.34
主管护师	86	279.83±30.54
副主任护师及以上	5	272.00±38.29
职务			0.94	0.39
临床护士	283	275.54±33.33
临床带教护士	18	285.00±31.00
护理管理者	8	267.63±35.99

项目	赋值
性别	女性=1；男性=2
年龄	<26岁=1；26~30岁=2；31~35岁=3；36~40岁=4；＞40岁=5
科室	综合ICU（0，0,0,0,0）；急诊ICU（1,0,0,0,0）；烧伤ICU（0,1,0,0,0）；呼吸ICU（0,0,1,0,0）；心脏ICU（0,0,0,1,0）；神经ICU（0,0,0,0,1）
护理工作年限	≤5年=1；6~10年=2；11~15年=3；16~20年=4；＞20年=5
ICU工作年限	≤5年=1；6~10年=2；11~15年=3；16~20年=4；＞20年=5
学历	专科及以下=1；本科=2；硕士及以上=3
职称	护士=1；护师=2；主管护师=3；副主任护师及以上=4
职务	临床护士=1；护理带教护士=2；护理管理者=3

自变量	回归系数	标准误	标准化回归系数	t	P
常数	270.97	11.30		23.99	<0.01
性别	−1.36	5.26	−0.02	−0.26	0.80
年龄	−0.91	4.16	−0.03	−0.22	0.83
科室（参照：综合ICU）
急诊ICU	−12.17	5.72	−0.12	−2.13	<0.05
烧伤ICU	−18.11	6.65	−0.16	−2.72	<0.05
呼吸ICU	0.34	7.55	0.003	0.05	0.96
心脏ICU	−7.21	6.05	−0.07	−1.19	0.23
神经ICU	−32.72	14.84	−0.13	−2.21	<0.05
护理工作年限	−10.20	4.81	−0.35	−2.12	<0.05
ICU工作年限	15.22	3.53	0.49	4.31	<0.01
职称	3.26	4.29	0.07	0.76	0.45
职务	4.66	5.46	0.05	0.85	0.39
学历	2.56	4.72	0.04	0.54	0.59