知信行模式在降低导管相关性血流感染中的应用效果  

Effect of application of the knowledge-attitude-practice model on the reduction of catheter-related bloodstream infections

作　　者：王密芳[1] 张丽萍[1] 蔡薇薇[1] 练红[1] 沙芬芳[1] 叶慧谦 WANG Mi-fang;ZHANG Li-ping;CAI Wei-wei;LIAN Hong;SHA Fen-fang;YE Hui-qian(The 2nd Affiliated Hospital of Wenzhou Medical University,Wenzhou,Zhejiang 325027,China)

机构地区：[1]温州医科大学附属第二医院成人ICU

出　　处：《中华医院感染学杂志》2019年第16期2542-2545,2560,共5页Chinese Journal of Nosocomiology

基　　金：浙江省温州市科技局科研基金资助项目(Y20150352)

摘　　要：目的应用知信行理论模式提高护士中心静脉导管集束化策略实施的依从性,以便控制导管相关性血流感染。方法本研究知信行理论模式实施对象为2016年1月-2017年6月在医院成人ICU工作的护士,选取2016年1月-2017年6月入住温州医科大学附属第二医院成人ICU,并由ICU医生置入中心静脉导管的患者184例为评价对象,其中2016年1月-2016年8月的87例患者列入对照组,2016年10月-2017年6月的97例患者列入试验组;2016年8月前,科室采用集中授课+示教为主的常规教育培训,2016年9月开始由静脉质量监控小组对ICU护士实施CRBSI集束化策略知信行干预;比较知信行模式运行前后两组患者CRBSI千日感染率及ICU护士对于集束化干预策略的依从性。结果最终纳入ICU护士36名,知信行干预后,ICU护士CRBSI集束化干预策略的依从性在知、信、行三方面的问卷评分均高于实施前(P<0.05);试验组患者CRBSI千日感染率1.1‰(1/913)低于对照组的7.3‰(6/818)(P<0.05)。结论知信行理论模式可提高ICU护士中心静脉导管集束化干预策略实施依从性,降低导管相关性血流感染。OBJECTIVE To improve the compliance of nurses to the implementation of central line bundle(CLB) with the help of the knowledge-attitude-practice(KAP) theoretical model, in order to control catheter-related bloodstream infections(CRBSI). METHODS The knowledge-attitude-practice theoretical mode was carried out by the nurses who worked in the adult ICU from Jan 2016 to Jun 2017. A total of 184 patients who were admitted to the adult ICU of the 2 nd Affiliated Hospital of Wenzhou Medical University from Jan. 2016 to Jun. 2017 and treated with peripherally inserted central catheter were selected as subjects. Among them, 87 patients from Jan. 2016 to Aug. 2016 were included in the control group, and 97 patients from Oct. 2016 to Jun. 2017 were included in the experimental group. Before Aug. 2016, the hospital departments used routine education and training which was focused on instructional and concentrated lecture teaching. Since Sep. 2016, the venous quality monitoring team conducted an intervention on the ICU nurses to implement the CRBSI clustering strategy in the KAP model. The CRBSI 1000-day infection rate and the ICU nurses’ compliance with the clustering intervention strategy were compared before and after the operation of the KAP model. RESULTS Totally 36 ICU nurses were finally included. After the intervention of KAP, the scores of questionnaires of knowledge, attitude and practice for compliance of CRBSI cluster intervention strategies of the ICU nurses were significantly higher after the mode was carried out than before it was carried out(P<0.05), the CRBSI 1000-day infection rate(1/913, 1.1‰) of the patients in the experimental group was significantly lower than that in the control group(6/818, 7.3‰)(P<0.05). CONCLUSION The KAP can improve nurses’ compliance with the peripherally inserted central catheter CRBSI clustering strategy and reduce catheter-related bloodstream infections.

关 键 词：知信行理论模式 集束化 导管相关性血流感染 

分 类 号：R47[医药卫生—护理学]