基于循证构建血液透析导管相关性血流感染早期识别及护理流程管理方案  

Based on evidence-based construction of early identification and nursing process management plan for hemodialysis catheters related blood stream infections

作　　者：刘兰霞[1] 张娟 刘嘉欣 肖长长[1] 陈少英[1] 罗丹 李桂兰[1] LIU Lanxia;ZHANG Juan;LIU Jiaxin;XIAO Zhangzhang;CHEN Shaoying;LUO Dan;LI Guilan(Houjie Hospital of Dongguan,Guangdong 523945 China)

机构地区：[1]东莞市厚街医院,广东523945

出　　处：《循证护理》2024年第3期421-426,共6页Chinese Evidence-Based Nursing

基　　金：东莞市社会发展科技项目,编号:20231800903472。

摘　　要：目的:基于循证构建血液透析导管相关性血流感染早期识别及护理流程管理方案,以期提高临床护理质量,降低血液透析病人导管相关性血流感染发生率。方法:基于循证护理的方法,检索、评价、汇总国内外关于预防血液透析导管相关性感染护理管理的最佳证据,构建导管相关性血流感染早期识别及护理流程管理方案基本框架,采用德尔菲专家咨询法对17名专家开展两轮函询,确定方案各级条目,通过层次分析法确定条目权重。结果:两轮函询专家权威系数依次为0.862,0.860;Kendall′s W值分别为0.546(χ^(2)=76.804,P<0.001)、0.614(χ^(2)=93.371,P=0.005),最终筛选并确定包括2个一级条目、10个二级条目、35个三级条目的早期识别及护理流程管理方案。结论:基于循证构建的血液透析导管相关性血流感染早期识别及护理流程管理方案科学、可靠,能够为血液透析病人导管相关性血流感染的早期识别和管理提供依据。Objective:To construct an evidence-based early identification and nursing process management plan for catheter-related bloodstream infections in hemodialysis patients,in order to improve clinical nursing quality and reduce the incidence of catheter-related bloodstream infections in hemodialysis patients.Methods:Based on evidence-based nursing,we searched,evaluated,and summarized the best evidence on nursing management for preventing catheter-related infections in hemodialysis at home and abroad.We constructed a basic framework for early identification and nursing process management of catheter-related bloodstream infections.We conducted two rounds of consultations with 17 experts using the Delphi expert consultation method to determine the items at all levels of the plan,and determined the weight of the items through the Analytic Hierarchy Process.Results:The authority coefficients of the two rounds of expert inquiry were 0.862 and 0.860,respectively.Kendall′s W values were 0.546(χ^(2)=76.804,P<0.001)and 0.614(χ^(2)=93.371,P=0.005).The final screening and determination included 2 level 1 items,10 level 2 items,and 35 level 3 items for early identification and nursing process management.Conclusion:The evidence-based early identification and nursing process management plan for catheter-related bloodstream infections in hemodialysis patients is scientific and reliable,and can provide a basis for the early identification and management of catheter-related bloodstream infections in hemodialysis patients.

关 键 词：循证 血液透析 导管相关性血流感染 早期识别 管理方案 循证护理 证据汇总 

分 类 号：R472[医药卫生—护理学]