PDCA循环管理模式对PICC置管患者门诊维护效果的Meta分析  

The effect of PDCA cycle management on the maintenance of PICC lines in outpatient department:A Meta-analysis

作　　者：蒋庆娟 文萃 应燕萍[2] 甘晓 韦艳[1] 赵慧函 JIANG Qingjuan;WEN Cui;YING Yanping;GAN Xiao;WEI Yan;ZHAO Huihan(Guangxi Medical University,Nanning,Guangxi,530021;Department of Nursing,The First Affiliated Hospital of Guangxi Medical University,Nanning,Guangxi,530021)

机构地区：[1]广西医科大学,广西南宁530021 [2]广西医科大学第一附属医院护理部,广西南宁530021

出　　处：《中西医结合护理（中英文）》2019年第9期37-41,共5页Journal of Clinical Nursing in Practice

基　　金：广西医疗卫生适宜技术研究与开发项目(S201524)

摘　　要：目的评价PDCA循环管理模式对经外周静脉置入中心静脉导管(PICC)患者门诊维护的效果。方法计算机检索Cochrane图书馆、JBI图书馆、PubMed、EMbase、MEDLINE、CINAHL、CNKI、VIP、CBM和WanFang Data等中英文数据库中关于PDCA循环管理模式对PICC置管患者门诊维护效果的随机对照试验。检索时间从建库至2019年1月28日。由2位研究者独立筛选文献、提取资料和评价纳入研究的偏倚风险后,采用RevMan 5.3软件对结果进行数据合并及Meta分析。结果最终纳入3项研究,共2431例患者,Meta分析结果表明,在PICC置管患者门诊维护中应用PDCA循环管理模式比常规护理更能有效减少导管相关并发症[RR=0.14,95%CI(0.10,0.20),P<0.01]、延长导管留置时间[RR=43.36,95%CI(25.13,61.59),P<0.01]、提高护理满意度[RR=0.48,95%CI(0.25,0.90),P=0.02]。结论在PICC置管患者门诊维护中应用PDCA循环管理模式可有效减少导管相关并发症,延长导管留置时间,提高导管门诊维护效果。但受纳入研究数量和质量限制,研究结论还需更多大样本、高质量的随机对照研究予以验证。Objective To evaluate the effect of plan-do-check-act(PDCA)cycle management on the maintenance of peripherally inserted central catheteR(PICC)lines in outpatient department.Methods The Cochrane Library,JBI Library,PubMed,EMbase,DLINE,CINAHL,CNKI,VIP,CBM and WanFang Data were searched.Randomized controlled trials(RCTs)about the effect of PDCA cycle management on the maintenance of PICC lines in outpatient department published before February 28th,2019 were included.AfteRtwo researchers independently screened the literature,extracted the data and evaluated the bias risk of included studies,the results were performed with RevMan5.3 software.Results A total of three papers were included involving 2431 patients in this review.The results of Meta-analysis showed that the application of PDCA cycle management in outpatient maintenance of PICC patients could reduce catheter-related complications more effectively than routine nursing(RR=0.14,95%CI[0.10,0.20],P<0.01),and longeRretention time(RR=43.36,95%CI[25.13,61.59],P<0.01)and higheRnursing satisfaction(RR=0.48,95%CI[0.25,0.90],P=0.02)were associated with application of PDCA cycle management.Conclusion Findings show that managers apply PDCA cycle management into outpatient maintenance of PICC patients can effectively reduce catheter-related complications,prolong catheteRretention time and improve the outpatient maintenance effect of catheters.However,due to the quantity and quality of the included study,the conclusions of need to be verified by more large samples and high quality RCTs.

关 键 词：经外周静脉置入中心静脉导管 PDCA 门诊维护 META分析 

分 类 号：R473.5[医药卫生—护理学]