基于PDCA循环法的心电定位技术培训在提高PICC置管尖端到位率中的应用  

Application of electrocardiograph positioning technology training based on PDCA cycle model in improving PICC tip positioning rate

作　　者：智晓旭[1] 陈传英[1] 孟爱凤[2] 施如春[1] 潘梦婷 茅昌敏[3] 刘春丽[3] 邾萍[2] 

机构地区：[1]江苏省肿瘤医院南京医科大学附属肿瘤医院门诊专科护理组,南京210009 [2]江苏省肿瘤医院南京医科大学附属肿瘤医院护理部,南京210009 [3]江苏省肿瘤医院南京医科大学附属肿瘤医院胸外科,南京210009

出　　处：《中华现代护理杂志》2017年第36期4578-4582,共5页Chinese Journal of Modern Nursing

基　　金：江苏省卫生计生委预防医学课题（Y2015063）;江苏省卫生计生委科研课题（N201601）

摘　　要：目的 探讨PDCA循环管理法结合心电导引在提高患者PICC置管过程中导管尖端到位率的效果研究.方法 2016年6月1日—9月31日应用PDCA循环管理法对江苏省肿瘤医院的36名静脉治疗护士进行包括腔内心电图辅助导管尖端定位等知识的培训,对培训前后护士理论知识及技能进行效果比较.结果 经培训的PICC置管护士理论与技能考核成绩均有提高,理论知识培训前（88.28±3.10）分,培训后（96.10±1.25）分,操作技能培训前（83.55±5.11）分,培训后（98.81±2.50）分,差异均有统计学意义（P〈0.05）;培训后PICC置管过程中导管尖端到位率提高,差异有统计学意义（χ^2=12.35,P〈0.05）;患者对置管人员的满意度从原来的88.7%上升至96.8%,差异有统计学意义（χ^2=10.79,P〈0.05）;操作时间培训前（40.23±3.56）min,培训后（28.76±4.34）min,差异有统计学意义（P〈0.05）.结论 运用PDCA循环法对静脉治疗护士进行培训,可提高护士对PICC置管过程中疑难问题的处理能力,有效提高PICC导管尖端到位率.Objective To investigate the effect of PDCA cycle management combing with ECG guidance in improving the rate of catheter tip in right place when is conducting the PICC catheterization. Methods A total of 36 intravenous treatment specialist nurses from Jiangsu Tumor Hospital were trained with PDCA cycle management method from 1st June to 31st September,2016. The training knowledge and skills included catheter tip positioning under intracardiac electrocardiogram. The knowledge and skills were analyzed and compared before and after training finally. Results The training not only could help to improve the score of knowledge and skill of PICC specialist nurses with knowledge before （88.28±3.10） and after （96.10±1.25） （P〈 0.05） and skill before （83.55±5.11） and after （98.81±2.50） （P〈 0.05）; but also increased the rate of catheter tip in right place in the process of PICC catheterization （χ^2=12.35,P 〈0.05）. Meanwhile, the results showed that patient satisfaction with nurses could also be improved from 88.7% to 96.8% （χ^2=10.79,P 〈0.05） and the operating time could be shorted [before （40.23±3.56）min,after （28.76±4.34）min]（P〈 0.05）. Conclusions The use of PDCA circulatory method to train nurses can improve the ability to deal with puzzling questions of nurses in the process of PICC catheterization,and increase the rate of PICC catheter tip in right place.

关 键 词：PDCA循环 心电定位技术(ECG) PICC 

分 类 号：R472[医药卫生—护理学]