多学科多部门集束化干预在促进PICC临床应用中的研究  

Multidisciplinary Multisectoral Cluster Intervention in Promoting the Clinical Application of PICC

作　　者：李冬梅[1] 黄石群 彭瑞娟[1] 胡敏芝[1] 蒙美好 LI Dongmei;HUANG Shiqun;PENG Ruijuan(Wuzhou Red Cross Hospital,Wuzhou 543002,China)

机构地区：[1]广西梧州市红十字会医院,广西梧州543002

出　　处：《中国医学创新》2019年第12期110-114,共5页Medical Innovation of China

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费科研课题(Z2016819)

摘　　要：目的:探讨多学科多部门集束化干预在促进PICC临床应用中的效果。方法:选择肿瘤科、普外科及妇科共9个科室2 695例患者为研究对象,将2015年4-12月住院的1 332例为干预前对象,将2016年12月-2017年10月住院的1 363例为干预后对象。针对影响PICC临床应用的多层面因素,护理部联合医务部、感控科、临床科室及PICC导管室等进行多学科多部门协作的集束化干预,并开展专项质量改善活动。比较集束化干预前后PICC应用率及患者与医护人员对应用PICC的满意度,评价专项质量改善活动前后外周静脉治疗患者药物外渗和渗出发生率。结果:干预前后PICC应用率分别为35.06%(467/1 332)、53.93%(735/1 363);干预前患者与医护人员对应用PICC的满意度平均得分分别为(40.17±3.78)、(41.76±4.12)分,干预后分别为(47.02±4.56)、(47.61±7.75)分,干预前后比较差异均有统计学意义(P<0.001)。专项质量改善活动前后外周静脉治疗患者药物外渗/渗出发生率分别31.80%、6.08%,改善前后比较差异有统计学意义(P<0.001)。结论:多学科多部门集束化干预可有效促进PICC的临床应用,提高患者与医护人员对应用PICC的满意度,减少外周静脉治疗患者药物外渗/渗出不良事件,确保用药安全。Objective:To explore the effect of multidisciplinary multisectoral cluster intervention in promoting the clinical application of PICC.Method:2 695 patients from 9 departments(Oncology,General Surgery and Gynecology)were selected as subjects.1 332 cases of hospitalization from April to December 2015 were pre-intervention targets.1 363 cases of hospitalization from December 2016 to October 2017 were targeted for intervention.In response to the multi-faceted factors affecting the clinical application of PICC,the Department of Nursing,in conjunction with the Medical Department,the Sensing Control Department,the Clinical Department and the PICC Catheter Room,conducted multi-disciplinary and multi-sectoral collaboration,and carried out special quality improvement activities.The application rate of PICC before and after the clustering intervention and the satisfaction of patients and medical staff on the application of PICC were compared,the incidence of drug extravasation/exudation in patients with peripheral venous treatment before and after special quality improvement activities were evaluated.Result:The PICC application rates before and after the intervention were 35.06%(467/1 332)and 53.93%(735/1 363).The average scores of satisfaction of patients and medical staff on the application of PICC before intervention were(40.17±3.78)and(41.76±4.12)scores,after intervention,they were(47.02±4.56)and(47.61±7.75)scores,the differences were statistically significant between before and after the intervention(P<0.001).The incidence of drug extravasation/exudation in patients with peripheral venous treatment before and after special quality improvement activities were 31.80% and 6.08%,the difference was statistically significant between before and after the intervention(P<0.001).Conclusion:Multidisciplinary multisectoral cluster intervention can effectively promote the clinical application of PICC,improve the satisfaction degree of the patients and medical staff in application of PICC,reduce the incidence of peripheral venou

关 键 词：PICC 临床应用 多学科多部门 集束化干预 质量改善 

分 类 号：R47[医药卫生—护理学]