基于JBI证据转化模式的外周静脉短导管选择与置入的最佳循证实践  

Best evidence-based practice of short peripheral venous catheter selection and insertion based on the JBI evidence transformation model

作　　者：刘巧艳 朱丽群[2] 步红兵[3] 尹卫[1] 黄贤凤[2] 许步慧 郑兰平 周英凤[4] Liu Qiaoyan;Zhu Liqun;Bu Hongbing;Yin Wei;Huang Xianfeng;Xu Buhui;Zheng Lanping;Zhou Yingfeng(Department of Endocrinology and Metabolism,Affiliated Hospital of Jiangsu University,Zhenjiang Jiangsu 212001;Department of Geriatrics,Affiliated Hospital of Jiangsu University,Zhenjiang Jiangsu 212001;Nursing Department,Affiliated Hospital of Jiangsu University,Zhenjiang Jiangsu 212001;School of Nursing,Fudan University,JBI evidence based Nursing cooperation center,Fudan University,Shanghai 200032)

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]复旦大学护理学院复旦大学JBI循证护理合作中心,上海200032

出　　处：《护士进修杂志》2021年第3期217-223,254,共8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)。

摘　　要：目的通过外周静脉短导管选择与置入最佳证据的应用,建立外周静脉短导管选择和置入的标准流程。方法通过对外周静脉短导管选择与置入相关主题的系统检索及质量评价,总结18条最佳证据,并结合临床情景和专业判断,制订12条基于证据的质量审查标准,在老年科和内分泌代谢科开展质量审查。结果(1)经2轮审查,12条审查指标达标率较前明显提高;证据应用后与应用前比较:外周静脉短导管并发症严重程度减轻,并发症发生率降低、导管留置时间延长,差异均有统计学意义(P<0.05)。(2)证据应用中与应用后比较:置管困难患者红外线使用率由42.35%提升至83.33%,使用红外线与未使用红外线找血管时间比较,差异均无统计学意义(P>0.05);使用红外线置管的患者穿刺时间较未使用红外线患者明显缩短,差异均有统计学意义(P<0.05)。(3)置管困难患者1次穿刺成功率由59.72%提升至83.33%。结论基于证据的质量审查项目可降低外周静脉短导管置管并发症并减轻其严重程度、延长导管留置时间,提高置管困难患者1次穿刺成功率,提高红外线使用率进而缩短穿刺时间,可改善患者体验,提高护士业务技能。Objective To establish a standard procedure for the selection and insertion of short peripheral intravenous catheters(SPIC)and reduce the incidence of complications through the application of the best evidence for the selection and insertion of SPIC.Methods 12 best evidences were summarized through systematic retrieval and quality evaluation of the topics related to the selection and insertion of SPIC.12 evidence-based quality examination standards were formulated based on clinical scenarios and professional judgment.Endocrinology and metabolism department and geriatric department carried out quality examination.Results After the second round of examination,the compliance rate of the 12 examination indicators was significantly higher than before;Comparison before and after the application of evidence,SPIC complications was significantly decreased(P<0.05),lien prolonged(P<0.05),increased utilization from the previous catheter in patients with difficult infrared,using infrared ray is not using infrared patients blood vessels to find time,there was no statistically significant difference(P>0.05),the puncture time significantly shortened(P<0.05),once puncture success rate increased.Conclusion Evidence-based quality review project can reduce the complications of SPIC,reduce the pain of patients,improve the success rate of one-time catheterization for patients with catheterization difficulties,shorten the puncture time and reduce the workload of nurses.

关 键 词：外周静脉短导管 选择与置入 循证护理 最佳实践 

分 类 号：R471[医药卫生—护理学]