PICC置管病人居家延续护理质量评价指标体系的构建及应用  

Construction and application of quality evaluation index system for continuing home care in PICC catheter patients

作　　者：龙国利 刘光维[1] LONG Guoli;LIU Guangwei(Department of Neurology,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016 China)

机构地区：[1]重庆医科大学附属第一医院神经内科,重庆400016 [2]四川省医学科学院·四川省人民医院

出　　处：《护理研究》2022年第14期2454-2460,共7页Chinese Nursing Research

基　　金：四川省卫生和计划生育委员会科研课题,编号:16PJ501。

摘　　要：目的:构建经外周静脉置入中心静脉导管(PICC)置管病人居家延续护理质量评价指标体系,并探讨其应用效果。方法:通过文献检索、专家访谈及专家函询构建PICC置管病人居家延续护理质量评价指标体系。选取2019年1月—2019年6月在我院首次进行PICC置管的100例病人作为对照组,选取2020年1月—2020年6月在我院首次进行PICC置管的100例病人作为研究组。对照组采用常规PICC置管病人居家延续护理方法进行护理,研究组根据制定的PICC置管病人居家延续护理质量评价指标体系对病人进行延续护理。比较两组病人导管留置时间、导管不良结局及PICC并发症发生率、病人对护理服务的满意度、每月居家延续护理频次、病人自我感受情况。结果:前2轮专家函询的专家函询表回收率均为100%,专家权威系数分别为0.8875和0.8842。第2轮专家函询3个等级指标的肯德尔和谐系数(Kendall's W)分别为0.566,0.561和0.557。最终形成包括3个一级条目、8个二级条目、39个三级条目的PICC置管病人居家延续护理质量评价指标体系。将其应用于PICC护理工作中,结果显示,研究组导管留置时间长于对照组,计划外拔管、导管脱出、导管堵塞发生率及皮肤受损、张力性水疱等PICC并发症发生率低于对照组,病人对护理服务的满意度高于对照组,每月居家延续护理频次多于对照组,病人自我感受好于对照组(均P<0.05)。结论:构建的PICC置管病人居家延续护理质量评价指标体系具有科学性,应用于临床可提高PICC置管病人居家延续护理质量。Objective:To construct quality evaluation index system for continuing home care in peripherally inserted central catheter(PICC)catheter patients and explore its application effect.Methods:Quality evaluation index system for continuing home care in PICC catheter patients was constructed by literature retrieval,expert interviews,expert consultation.100 patients who performed PICC for the first time in our hospital from January 2019 to June 2019 were selected as control group,100 patients who performed PICC for the first time in our hospital from January 2020 to June 2020 were selected as research group.Conventional continuing home care method was applicated on PICC catheter patients in control group,continuing care based on quality evaluation index system for continuing home care in PICC catheter patients was applicated on patients in research group.To compare catheter reservation time,incidence rates of adverse catheter outcomes and PICC complications,patients'satisfaction for nursing services,frequent continuing home care each month,and patients'self⁃experience in two groups.Results:The recovery rate of inquiry table of experts in the first two rounds of expert consultation both were 100%,and the authoritative coefficients were 0.8875 and 0.8842,respectively.In the second round of experts,the Kendall's harmonious sauce(Kendall's W)of the 3 level indicators were 0.566,0.561 and 0.557,respectively.Finally,the formed quality evaluation index system for continuing home care in PICC catheter patients included 3 first⁃level indexes,8 second⁃level indexes and 39 third⁃level indexes.It was applied to the PICC care work.The results showed that catheter reservation time of research group was longer than that of control group.The incidence rates of exterior pipes,catheter removal,catheter blocking,skin damage,tension blisters of research group were lower than that of control group.Patients'satisfaction for nursing services of research group was higher than that of control group.Frequent continuing home care each mon

关 键 词：经外周静脉置入中心静脉置管 PICC 延续护理 护理质量 评价体系 德尔菲法 

分 类 号：R472[医药卫生—护理学]