中心静脉通路装置穿刺部位维护状况调查  

Investigation on nurses′maintenance practice at the puncture site of central venous access devices

作　　者：何云艳 张静 郭怡雪 魏晓宇 陈永侠[3] 叶萍[3] 白茹[3] He Yunyan;Zhang Jing;Guo Yixue;Wei Xiaoyu;Chen Yongxia;Ye Ping;Bai Ru(Nursing School of Bengbu Medical College,Bengbu 233030,China)

机构地区：[1]蚌埠医学院护理学院,安徽蚌埠233030 [2]蚌埠医学院第二附属医院 [3]蚌埠医学院第一附属医院

出　　处：《护理学杂志》2018年第20期47-51,共5页Journal of Nursing Science

基　　金：安徽高校自然科学研究项目(KJ2017A214);蚌埠医学院2017年度研究生科研创新计划(Byycx1719);2016年安徽高校人文社会科学重点研究项目(SK2016A0604)

摘　　要：目的分析三甲医院就诊患者中心静脉通路装置(CVADs)穿刺部位的维护现状,为临床输液治疗的护理管理和研究提供数据支持和参考。方法采用方便抽样选取安徽省8所三甲医院的375名临床护理人员行CVADs穿刺部位维护现状调查。结果具有正式血管通路认证证书的护士占72.0%;选择7d更换1次敷料占72.5%;选用含氯己定成分的抗菌溶液占24.3%;使用导管固定装置占79.2%;穿刺部位皮肤发红、发炎时,使用透明敷料为42.7%;当穿刺部位皮肤化脓引流时,仅有37.3%护理人员对CVADs穿刺部位维护具有信心。结论来自8所三甲医院护理人员的CVADs维护实践操作存在差异性,CVADs穿刺部位维护流程有待进一步规范和完善,同时应对护理人员加大培训力度。Objective To analyze the status of maintenance practice at the puncture site of central venous access devices by nurses working in 3A hospitals,and to provide data support for future research and nursing management of intravenous infusion therapy.Methods A convenient sampling method was used to select 375 clinical nurses from eight 3A hospitals in Anhui Province,and the participants were asked to fill out a questionnaire regarding the maintenance practice at the puncture site of central venous access devices.Results Totally,72%of the nurses held the certificates of vascular access maintenance practice.As for the maintenance practice,72.5%changed the dressings every 7 days,24.3%selected chlorhexidine as skin disinfectant,79.2%preferred catheter fixation device for securement of vascular access,42.7%utilized transparent dressing if the puncture site skin turned red or inflammatory,and only 37.3%had confidence in maintenance when the puncture site skin became purulent and in need of drainage.Conclusion There are differences in maintenance practice at the puncture site of central venous access devices practice by nurses from the 8 hospitals.Maintenance practice remains to be standardized and improved.Further training of nurses is necessary.

关 键 词：中心静脉通路装置 穿刺部位 维护 敷料 氯己定 皮肤化脓 导管相关血流感染 

分 类 号：R472[医药卫生—护理学]