专科护士团队实施外周中心静脉置管导管全周期管理的研究  

Study on the whole cycle management of peripheral central venous catheter management of specialized nurse team

作　　者：杨海红[1] 黄玲[1] 戴莉[1] 陈秋香[2] Yang Haihong;Huang Ling;Dai Li;Chen Qiuxiang(Hubei Qianjiang Central Hospital,Qianjiang Hubei 433199;Renmin Hospital of Wuhan University,Wuhan Hubei 433100)

机构地区：[1]湖北省潜江市中心医院,湖北潜江433199 [2]武汉大学人民医院,湖北武汉433100

出　　处：《护士进修杂志》2021年第23期2155-2159,共5页Journal of Nurses Training

基　　金：湖北省卫生健康委员会项目(编号:WJ2019M106);湖北省潜江市公益性行业科研立项项目(编号:2021-5)。

摘　　要：目的探讨专科护士团队实施外周中心静脉置管(Peripherally inserted central catheter,PICC)导管置管前、置管中、置管后、居家带管及拔管期间全周期管理的效果。方法对PICC带管患者需求以及院内临床科室需求进行分析,构建PICC全流程管理方案,主要包括重视专科护理队伍建设,构建院内PICC专科护士三级管理组织构架;开展PICC专科护士主导的PICC全周期管理。设立对照组(2018年7月-2019年6月)与观察组(2019年7月-2020年6月),对比2组患者PICC置管主要并发症(包括PICC导管相关性血栓、堵管、穿刺点渗血、炎症、静脉炎以及导管外露)的发生率、非计划拔管发生率以及患者满意度。结果专科护士团队实施PICC全周期管理,可以降低PICC导管相关性血栓发生率和堵管、穿刺点渗血、炎症、静脉炎以及导管外露的发生率、降低非计划拔管发生率,2组各项统计指标相比,观察组均下降,差异具有统计学意义(P<0.05)。观察组患者满意度较对照组高,2组差异具有统计学意义(P<0.05)。结论以专科护士团队为主导的PICC全周期管理,有助于促进专科护理队伍建设,降低PICC相关并发症发生率,提高患者满意度。Objective To explore the effect of specialized nurse team on performing full-cycle management of peripherally inserted central catheter(PICC)before,during,after,at home and during PICC insertion.Methods The requirements of PICC patients and clinical departments in the hospital were analyzed,and the whole process management scheme of PICC was constructed,which mainly included:pay attention to the construction of specialized nursing team,and construct the three-level management organization framework of PICC specialized nurses in the hospital;Full-cycle management of PICC led by PICC specialist nurses was carried out.Observation group and control group were set up to compare the incidence of major complications,unplanned extubation and patient satisfaction in patients with PICC.Results The whole cycle management of peripheral central venous catheterization by the specialist nurse team could reduce the incidence of PICC catheter-related thrombosis,the incidence of bleeding,inflammation,phlebitis and catheter exposure and the incidence of unplanned extubation.Compared with the two groups,all statistical indicators in the experimental group were decreased.There was statistically significant differences(P<0.05).The satisfaction of patients in experimental group was improved,and the difference between the two groups was statistically significant(P<0.05).Conclusion Full-cycle management of peripheral central venous catheterization led by specialized nurse team is helpful to promote the construction of specialized nursing team,reduce the incidence of PICC-related complications and improve patient satisfaction.

关 键 词：经外周中心静脉置管 全周期管理 专科护士 分层使用 患者满意度 管道安全 

分 类 号：R472[医药卫生—护理学]