Preventive effect of refined non-artificial-airway nursing protocol on stroke-associated pneumonia

Kong Chaoping; Li Lulu; Liu Qiaoyun; Fu Ting; Rui Yuling; Zhou Ying; Wang Huiqi

doi:10.11986/j.issn.1673-873X.2025.11.06

Abstract：Objective To evaluate the preventive effect of a refined non-artificial-airway nursing protocol on stroke-associated pneumonia(SAP),so as to provide evidence for optimizing SAP nursing interventions.Methods From March 2023 to De-cember 2024,158 acute stroke patients admitted to Nanjing Gaochun People's Hospital were enrolled and assigned by a ran-dom number table to a control group and an observation group,with 79 cases each.The control group received routine nurs-ing;the observation group received a refined non-artificial-airway nursing protocol.Outcomes compared included SAP inci-dence,SAP duration,Clinical Pulmonary Infection Score(CPIS),and length of ICU stay.Pulmonary function(forced ex-piratory volume in 1 second[FEV1],maximum voluntary ventilation[MVV],and vital capacity[VC])was recorded be-fore and after intervention.Swallowing function and oral hygiene were assessed before and after intervention using the Standardized Swallowing Assessment(SSA)and a modified Beck oral score(for comatose or uncooperative patients assessed by clinical observation and nursing records).Quality of life was evaluated before and after intervention by the WHO Quality of Life-BREF(WHOQOL-BREF).Results The observation group had significantly lower SAP incidence and CPIS score,and shorter SAP duration and length of ICU stay than the control group(P＜0.05).Before intervention,there were no sig-nificant differences between groups in FEV1,MVV,or VC(P＞0.05).After intervention,FEV1,MVV,and VC in both groups increased compared with before intervention,and values in the observation group were greater than those in the con-trol group,with statistically significant differences(P＜0.05).Before intervention,SSA and modified Beck oral scores did not differ significantly between groups(P＞0.05);after intervention,both scores decreased in both groups versus baseline,and the observation group had lower scores than the control group,with statistically significant differences(P＜0.05).Be-fore intervention,WHOQOL-BREF scores did not differ significantly between groups(P＞0.05);after intervention,WHOQOL-BREF scores increased in both groups and were higher in the observation group than the control group,with sta-tistically significant differences(P＜0.05).Conclusion A refined non-artificial-airway nursing protocol that integrates risk assessment with coordinated management of swallowing,respiratory function,and oral hygiene can significantly reduce the risk of SAP and improve patient outcomes,indicating high clinical promotion value.