预防中心静脉导管相关性血流感染集束化护理的效果观察  

Effect of cluster nursing on prevention of central venous catheter-related bloodstream infections

作　　者：陆蕾[1] 吴蕾[1] 刘琼[2] 

机构地区：[1]东南大学医学院附属江阴医院心血管内科,江苏江阴214400 [2]东南大学医学院附属江阴医院重症监护室,江苏江阴214400

出　　处：《中华医院感染学杂志》2014年第22期5548-5550,共3页Chinese Journal of Nosocomiology

基　　金：江苏省卫生厅重点学科基金资助项目(KF201207)

摘　　要：目的探讨集束化护理预防重症监护病房(ICU)中心静脉导管相关性血流感染(CRBSI)的效果,为临床降低CRBSI发生率制定针对性干预措施。方法选择2012年2月-2013年6月ICU收治的行中心静脉导管置管患者163例,分为对照组80例和观察组83例;对照组患者给予常规护理,观察组患者给予集束化护理;记录两组患者置管部位、置管时间、感染情况以及感染病例病原菌构成。结果对照组和观察组患者置管时间分别为11.90d和10.84d;对照组置管部位中颈内静脉、锁骨下静脉和股静脉分别有8、61例和11例,观察组分别有10、67例和6例;两组患者在置管部位、置管时间方面差异无统计学意义;观察组患者CRBSI发生率显著低于对照组,分别为1.20%和8.75%,差异有统计学意义。结论集束化护理可降低ICU CRBSI的发生率,应加强ICU集束化护理的应用。OBJECTIVE To explore the effect of cluster nursing on prevention of central venous catheter‐related bloodstream infections （CRBSI） in intensive care units （ICUs） so as to put forward targeted interventions to re‐duce the incidence of CRBSI .METHODS A total of 163 patients who underwent central venous catheterization in the ICUs from Feb 2012 to Jun 2013 were enrolled in the study and divided into the control group with 80 cases and the observation group with 83 cases ;the control group was treated with the conventional nursing ,the obser‐vation group was received the cluster nursing ;the catheterization sites ,catheter indwelling time ,incidence of in‐fections ,and distribution of pathogens were recorded and compared between the two groups .RESULTS The cathe‐ter indwelling time was 11 .90 days in the control group ,10 .84 days in the observation group .There were 8 cases of patients with the jugular vein as the catheterization site in the control group and 10 cases in the observation group;there were 61 cases of patients with the subclavian vein as the catheterization site in the control group and 67 cases in the observation group ;there were 11 cases of patients with the femoral vein as the catheterization site in the control group and 6 cases in the observation group ;there was no statistically significant difference in the catheterization site or the catheter indwelling time between the two groups .The incidence rate of CRBSI was 1 .20% in the observation group ,significantly lower than 8 .75% in the control group ,the difference was statisti‐cally significant .CONCLUSION The cluster nursing can contribute to the reduction of incidence of CRBSI in the ICUs ,and it is necessary to strengthen the application of the cluster nursing in the ICUs .

关 键 词：集束化护理 重症监护 中心静脉导管 感染 

分 类 号：R181.32[医药卫生—流行病学]