经外周置入中心静脉导管相关血流感染预防的最佳证据总结  

Summary of the best evidence for prevention of bloodstream infections associated with peripherally inserted central catheters

作　　者：王春立[1] 吴思婷 吴心怡[1] 武莹[2] 丁亚光[3] Wang Chunli;Wu Siting;Wu Xinyi;Wu Ying;Ding Yaguang(Department of Nursing,Beijing Children's Hospital,Capital Medical University,National Center for Children's Health,China,Beijing 100045,China;Department of Oncology,Beijing Children's Hospital,Capital Medical University,National Center for Children's Health,China,Beijing 100045,China;Department of Blood Therapy,Beijing Children's Hospital,Capital Medical University,National Center for Children's Health,China,Beijing 100045,China)

机构地区：[1]国家儿童医学中心,首都医科大学附属北京儿童医院护理部,北京100045 [2]国家儿童医学中心,首都医科大学附属北京儿童医院肿瘤内科,北京100045 [3]国家儿童医学中心,首都医科大学附属北京儿童医院血液治疗室,北京100045

出　　处：《中华现代护理杂志》2022年第31期4324-4330,共7页Chinese Journal of Modern Nursing

基　　金：首都医科大学附属北京儿童医院护理专项基金(YHL201901);中华医学会杂志社2021—2022年护理学科研究课题(CMAPH-NRI2021044)。

摘　　要：目的检索并总结经外周置入中心静脉导管(PICC)相关血流感染预防的最佳证据,并对证据进行评价,为临床执行预防导管相关血流感染的措施提供参考。方法检索英国国家临床医学研究所指南库(NICE)、美国指南网(NGC)、国际指南协作网(GIN)、苏格兰学院指南网(SIGN)、澳大利亚Joanna Briggs Institute(JBI)循证卫生保健中心数据库、UpToDate、BMJ Best Practice、Cochrane Library、中国知网、万方以及相关专业网站美国静脉输液护理学会、医脉通和国家卫生健康委员会官网等涉及PICC导管相关血流感染预防的所有临床决策、指南、专家共识、证据总结、系统评价,检索时限为建库至2021年5月。由4名研究者对文献进行质量评价,2名研究者进行证据的提取总结。结果共纳入9篇文献,其中1篇临床决策,1篇实践标准,4篇指南,3篇证据总结。从组织管理、输液工具选择、置管维护及使用、健康教育、拔管等5个方面最终纳入29条证据。结论PICC导管相关血流感染预防的最佳证据总结涉及面广,管理者及临床医护人员应结合具体医疗情境进行证据的应用,减少临床PICC导管相关血流感染的发生。Objective To retrieve and summarize the best evidence of peripherally inserted central catheters(PICC)related bloodstream infection prevention and to evaluate the evidence,so as to provide reference for clinical implementation of preventive measures for catheter-related bloodstream infection.Methods National Institute for Health and Care Excellence(NICE),National Guideline Clearinghouse(NGC),Guidelines International Network(GIN),Scottish Intercollegiate Guidelines Network(SIGN),Australian Joanna Briggs Institute(JBI)Evidence-based Health Centre Database,UpToDate,BMJ Best Practice,Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang and related professional websites such as Infusion Nursing Society(INS),Medlive and official website of the National Health Commission were searched for all clinical decisions,guidelines,expert consensus,evidence summary and systematic reviews related to the prevention of PICC catheter-related bloodstream infections.The retrieval time limit was from the establishment of the databases to May 2021.Four researchers evaluated the quality of the literature,and two researchers extracted and summarized the evidence.Results A total of 9 articles were included,including 1 clinical decision,1 standard of practice,4 guidelines and 3 evidence summaries.Finally,29 pieces of evidence were included from 5 dimensions,including organization management,infusion tool selection,catheterization maintenance and use,health education and extubation.Conclusions The summary of the best evidence for the prevention of PICC related bloodstream infection covers a wide range of areas.Managers and clinical medical staff should apply the evidence according to the specific medical situation to reduce the occurrence of clinical PICC catheter-related bloodstream infection.

关 键 词：血流感染 预防 经外周置入中心静脉导管 证据总结 

分 类 号：R472[医药卫生—护理学]