外周静脉短导管选择与置入的最佳证据分析  

Best evidence summary for selection and insertion of short peripheral intravenous catheters

作　　者：刘巧艳 朱丽群[2] 周英凤[5] 李全磊[6] 曹松梅[3] 步红兵[1] 黄贤凤[2] 尹卫[1] 郑兰平 阎蕾[3] Liu Qiaoyan;Zhu Liqun;Zhou Yingfeng;Li Quanlei;Cao Songmei;Bu Hongbing;Yin Wei;Huang Xianfeng;Zheng Lanping;Yan Lei(Affiliated Hospital of Jiangsu University,Department of Endocrine metabolism,Shanghai 200032;Affiliated Hospital of Jiangsu University,Department of Geriatrics,Shanghai 200032;Affiliated Hospital of Jiangsu University,Nursing Department,Shanghai 200032;Affiliated Hospital of Jiangsu University,Urology and Thyroid Surgery;School of Nursing of Fudan University,Shanghai 200032;School of Nursing,Johns Hopkins University,USA 21205)

机构地区：[1]江苏大学附属医院内分泌代谢科,江苏镇江212001 [2]江苏大学附属医院老年科,江苏镇江212001 [3]江苏大学附属医院护理部,江苏镇江212001 [4]江苏大学附属医院泌尿甲状腺外科,江苏镇江212001 [5]复旦大学护理学院,上海200032 [6]约翰霍普金斯大学护理学院,美国巴尔的摩21205

出　　处：《护士进修杂志》2020年第6期550-555,共6页Journal of Nurses Training

基　　金：复旦大学循证护理中心证据转化与临床应用项目(编号:Fudanebn201809);江苏省镇江市科技创新资金政策引导计划-软科学研究项目(编号:PK2019029)。

摘　　要：目的遴选并获取外周静脉短导管选择与置入的相关证据,并对最佳证据进行总结。方法检索Best Practice(BMJ)、Joanna Briggs Institute循证卫生保健中心数据库、Cochrane Library、加拿大安大略注册护士协会、美国静脉输液护理学会、美国指南网、英国国家临床医学研究所指南库及医脉通临床指南网等关于外周静脉短导管选择与置入的所有证据,包括临床实践指南(近5年)、证据总结、系统评价等。由2名研究者对纳入的文献质量进行独立评价,并对符合质量标准的文献进行证据提取。结果结合专业人员的判断,总结出18条外周静脉短导管选择与转入方面的最佳证据。包括输液适应症、导管及穿刺部位的选择、患者教育、止血带及穿刺部位准备、麻醉剂的应用、置管困难或穿刺失败的措施、导管更换及敷料固定8个方面。结论临床护理人员应把握输注适应症、谨慎选择目标血管,保证患者安全;同时,在置入环节对置管困难患者积极尝试可视化、加热及无痛技术,提高置管成功率,减少患者不适。Objective To screen and obtain relevant evidence on selection and insertion of short peripheral intravenous catheters,and to summarize the best available evidence.Methods We searched the BMJ best practice,Joanna Briggs institute(JBI),Cochrane library,registered nurses,association of Ontario(RNAO),infusion nurses society(INS),national guideline clearinghouse(NGC),national institute for health and care excellence(NICE),Medlive,etc,to collect literature including clinical practice guideline(recent five years),evidence summary and systematic review regarding selection and insertion of short peripheral intravenous catheters.Two reviewers independently performed quality appraisal for included studies,and evidence was extracted for those meeting quality requirements.Results Combined with judgment of clinical professionals,totally 18 evidences selected,including indications for infusion,selection of catheter and puncture site,patient education,preparation of tourniquet and puncture site,application of anesthetics,measures for difficult or failed catheterization,catheter replacement and dressing fixation.Conclusion Nurses should pay attention to indications for intravenous infusion,cautiously select target veins to guarantee patient safety;for patients with difficult catheterization,visualization,warming,and painless techniques should be actively adopted to improve the success rate of catheterization and reduce patients’discomfort.

关 键 词：外周静脉短导管 置管 证据总结 

分 类 号：R47[医药卫生—护理学] R472[医药卫生—临床医学]