基于多准则决策分析法构建无隧道和涤纶套导管集束化护理策略  

Construction of a clustered nursing strategy for non-cuffed catheter based on multi-criteria decision analysis method

作　　者：任昱燊 陈娜 王晓萍[2] 权月[2] 倪巍莲 向洋 常攀 田丽[2] REN Yu-shen;CHEN Na;WANG Xiao-ping;QUAN Yue;NI Wei-lian;XIANG Yang;CHANG Pan;TIAN Li(Intensive Care Medicine,Tianjin Third Central Hospital,Tianjin 300170,China;Department of Nursing,Tianjin Third Central Hospital,Tianjin 300170,China)

机构地区：[1]天津市第三中心医院重症医学科,天津300170 [2]天津市第三中心医院护理部,天津300170

出　　处：《中国血液净化》2024年第2期147-151,共5页Chinese Journal of Blood Purification

基　　金：天津市卫生健康科技项目(TJWJ2022QN044);天津市医学重点学科(专科)建设项目(TJYXZDXK-025A)。

摘　　要：目的 基于多准则决策分析法(multi-criteria decision analysis,MCDA)构建血液透析(hemodialysis,HD)患者无隧道和涤纶套导管(non-cuffed catheter,NCC)集束化护理策略。方法 系统检索美国国立指南文库、国际指南协作网、安达略注册护士协会、中国医脉通等指南网和Pubmed、Embase、Medline数据库、Cochrane图书馆、中国知网、维普、万方和中国生物医学文献数据库中有关NCC护理的相关文献。检索时间为2010年1月—2022年7月。由10名血液透析、血管通路、感染控制相关领域专家采用基于MCDA分析法形成NCC集束化护理策略,将集束化护理策略进行初步应用,验证其临床可行性。结果10名函询专家权威系数为0.88,根据得分从高到低排序最终形成8项护理策略,分别为无菌技术(590.45分)、导管出口部位护理(587.65分)、冲管护理(585.25分)、封管护理(582.75分)、敷料的更换与选择(574.83分)、置管操作(573.85分)、维护评估(573.40分)、导管接头护理(573.12分)。结论 运用MCDA科学构建的NCC集束化护理策略具有一定临床实用性,将在使用过程中不断优化,提高患者生活质量。Objective To construct a clustered nursing strategy for tunnel-free and non-cuffed catheter(NCC)in hemodialysis(HD)patients using multi-criteria decision analysis(MCDA)method.Methods We systematically searched for relevant literature on NCC nursing from the National Guidelines Library of the United States,the International Guidelines Collaboration Network,the Ontario Registered Nurses Association,the China Medical Association Guidelines Network,Pubmed,Embase,Medline databases,Cochrane Library,CNKI,VIP,Wanfang,and the China Biomedical Literature Database.The search period is from January 2010 to July 2022.Ten experts in the fields of hemodialysis,vascular access,and infection control used MCDA method to form a NCC cluster nursing strategy,which was preliminarily applied to verify its clinical feasibili-ty.Results The authority coefficient of the 10 consultation experts was 0.88.Based on the ranking of scores from high to low,8 optimized nursing strategies were formed,namely sterile technology(590.45),care of the catheter outlet area(587.65),flushing tube care(585.25),sealing care(582.75),replacement and selection of dressing(574.83),tubing operation(573.85),maintenance evaluation(573.40),and catheter joint care(573.12).Conclusions The NCC cluster nursing strategy constructed using MCDA science is clinically prac-ticable and will be continuously optimized after use to improve patient quality of life.

关 键 词：多准则决策分析 透析导管 集束化护理 

分 类 号：R473[医药卫生—护理学]