Abstract:

Objective

To explore the effects of omnidirectional non-blind spot management model under early warning mechanism on hospital stay and occurrence of adverse events in patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD） complicated with respiratory failure （RF）.

Methods

All of 129 patients with AECOPD and RF admitted to department of the hospital from January 2022 to January 2024 were selected and randomly divided into observation group （n=65） and control group （n=64）by the single-double number method.The control group was given routine management model while the observation group was given omnidirectional non-blind spot management model under early warning mechanism.The differences in treatment time and hospital stay （ICU treatment time，mechanical ventilation time，hospital stay） were compared between the two groups of patients，and the differences in comfort ［Kolcaba General Comfort Questionnaire （GCQ）］ and quality of life ［St George's Respiratory Questionnaire （SGRQ）］ before and after intervention and occurrence of adverse events ［ventilator-associated pneumonia（VAP），ventilator dependence （VD），pipeline blockage，mask leakage，asphyxia］ during hospitalization were analyzed.

Results

The ICU treatment time，mechanical ventilation time and hospital stay with （16.68±2.01） d，（8.28±1.36）d and （29.44±3.95） d in observation group were shorter than （16.68±2.01） d，（8.28±1.36） d and （29.44±3.95） d in control group （P＜0.01）.After intervention，the comfort scores of physiology，psychology，society and environment in the two groups were increased compared with those before intervention （P＜0.05），and after intervention，the physiological score （18.74±3.04），psychological score （31.88±3.54），social score （27.74±3.68） and environmental comfort score （18.26±2.74） in the observation group were higher than those in the control group （14.28±2.57），（23.69±3.28） and （22.38±3.19），（15.64±2.47） （P＜0.05）.The scores of respiratory symptoms，activity limitation and disease impact in the two groups were decreased after intervention compared to before treatment （P＜0.05），and the respiratory symptom score （37.64±4.21），activity limitation score （36.37±4.64） and disease impact score （38.28±4.97） of the observation group after intervention were lower than those of the control group （40.25±4.85），（36.37±4.64） and （44.37±4.58） （P＜0.05）.During hospitalization，the incidence rate of total adverse events in observation group with 6.15% was lower compared with 20.31% in control group （P ＜0.05）.

Conclusion

The application of omnidirectional non-blind spot management model under early warning mechanism in AECOPD with RF is helpful for the treatment progress of patients，and can shorten the hospitalization treatment time，control the occurrence of adverse events，and improve the comfort and quality of life.

Key words: Acute exacerbation of chronic obstructive pulmonary disease, Early warning mechanism, Omnidirectional non-blind spot management, Adverse events