降低无陪病房患儿外周静脉短导管意外拔管率的循证实践  

Evidence-based practices for reducing unplanned extubation incidence of peripheral venous catheter in non-accompanying ward children

作　　者：雷佳芳 刘晓姝[1] 候小芹[1] 晏萍兰[1] 刘华凤[1] 熊婷芳 涂满梅[1] 虞露艳 Lei Jiafang;Liu Xiaoshu;Hou Xiaoqin;Yan Pinglan;Liu Huafeng;Xiong Tingfang;Tu Manmei;Yu Luyan(Jiangxi Province Children's Hospital,Jiangxi,Nanchang,330006;Children's Hospital of Zhejiang University School of Medicine,Zhejiang,Hangzhou,310052)

机构地区：[1]江西省儿童医院,江西南昌330006 [2]浙江大学附属儿童医院,浙江杭州310052

出　　处：《护士进修杂志》2021年第17期1557-1564,共8页Journal of Nurses Training

摘　　要：目的通过在儿童无陪病房实施循证变革,降低外周静脉短导管意外拔管率。方法围绕“降低儿童外周静脉留置针意外拔管率”相关主题词检索文献,提取证据,FAME评价后取得15条证据,聚类为5个维度;制定31条审查指标;基线审查把握实施科室现况,障碍因素分析后制定实践变革内容,变革场所为新生儿外科。结果多数证据执行率升高,2条证据审查3次差别不大;患儿留置针意外拔管率下降、留置时间延长、住院期间平均穿刺次数下降,护士循证知识水平提高(均P<0.05)。结论在儿童无陪病房实施循证护理可有效降低外周静脉留置针意外拔管率、提升科室护理管理质量。Objective To implement evidence-based practices in the non-accompanying ward to reduce the unexpected extubation incidence of children's peripheral venous catheter(PVC).Methods Literature search mainly around the topic of reducing the unexpected extubation incidence of children's PVC,extracted and evaluated the best evidence.15 evidences were chosen and classified into 5 types,31 audit criteria were developed.Baseline review was conducted to analyze the application barriers and available resources,then the evidences were introduce into the department of neonatal surgery.Results The compliance rate of evidence were increased except two evidences,The unplanned extubation incidence of PVC and puncture frequency were decreased,PVC lien prolonged,the level of evidence-based knowledge of nurses was improved.Conclusion Implement evidence-based practices in the non-accompanying ward can decrease the rate of PVC unexpected extubation,improve the quality of nursing management.

关 键 词：外周静脉短导管 意外拔管率 儿童 循证护理 

分 类 号：R471[医药卫生—护理学]