基于改进科学降低儿童PICC导管相关性血流感染的循证护理实践  

Evidence-based nursing practice of reducing the incidence of PICC Catheter Related Bloodstream Infection in pediatric patients based on improvement science

作　　者：丁亚光[1] 王春立[1] 迟巍[1] 王晓晖[2] 王莹莹 王莉[1] 武莹[1] 陈芳娇[1] 段颖杰[1] 李慧君[1] DING Yaguang;WANG Chunli;CHI Wei;WANG Xiaohui;WANG Yingying;WANG Li;WU Ying;CHEN Fangjiao;DUAN Yingjie;LI Huijun(Nursing Department,Beijing Children's Hospital,Capital Medical University,National Center for Children's Health,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,北京市100045 [2]国家儿童医学中心,首都医科大学附属北京儿童医院院感办公室,北京市100045

出　　处：《中国护理管理》2024年第8期1130-1135,共6页Chinese Nursing Management

基　　金：中华护理学会2022年度立项科研课题(ZHKY202202)。

摘　　要：目的:探索基于改进科学的循证护理实践在降低PICC导管相关性血流感染发生率的方面的效果,以提升临床护理质量。方法:采取前后对照研究设计,采用便利抽样法,选取2021年1月至2022年12月北京市某三级甲等儿童医院病房有PICC置管的患儿以及病房护士为研究对象。对照组于2021年1月—12月,采用常规PICC导管感染防控措施,实验组于2022年1月—12月,采用改进科学中改进策略中的六西格玛方法,比较两组患儿导管相关性血流感染发生率以及护士对导管相关知识掌握情况。结果:实验组患儿PICC导管相关性血流感染发生率为0.9%,低于对照组患儿的2.4%,实验组每千导管日感染发生率为0.4‰,低于对照组患儿的1.0‰;实验组护士对于PICC导管相关性血流感染防控知识问卷各维度得分均高于对照组得分(P<0.05)。结论:基于改进科学的循证护理实践可有效降低PICC留置期间导管相关性血流感染发生率,提升护士对于导管感染防控知识掌握水平,提升临床护理的工作质量。Objective:To explore the effects of application of improvement science in reducing the incidence of PICC Catheter Related Bloodstream Infection(CRBSI)based on evidence-based medicine.Methods:In this study,a convenience sampling method was adopted to select children with PICC in the wards of a tertiary grade A children's hospital and nurses in the ward from January 2020 to December 2022.The control group adopted conventional PICC infection prevention and control measures,while the experimental group adopted the six sigma in the improved science strategy.The incidence of CRBSI and the nurses'knowledge in the two groups was analysed.Results:The incidence of PICC CRBSI of the experimental group was significantly lower than that of the control group(0.9%VS.2.4%).The incidence of infection per thousand PICC of the experimental group was significantly lower than that of the control group(0.41‰VS.1.0‰).The nurses'knowledge of infection prevention and infection control of PICC was higher than that of the control group,and the difference was statistically significant(P<0.05).Conclusion:Evidence-based nursing practice based on improvement science can effectively reduce the incidence of PICC CRBSI,improve nurses'knowledge of catheter infection prevention and control,and improve the quality of clinical nursing work.

关 键 词：改进科学 经外周静脉置入中心静脉导管 导管相关性血流感染 循证护理实践 

分 类 号：R47[医药卫生—护理学] R197[医药卫生—临床医学]