患儿经中心静脉导管采血的循证护理实践  

Evidence-Based Nursing Practice of Blood Collection through Central Venous Catheter in Children

作　　者：李燕秋 付秀云 张彩凤 盛熔 卢家盛 苏茜 邹丹 彭美晴 LI Yanqiu;FU Xiuyun;ZHANG Caifeng(Women and Children's Medical Center Affiliated to Guangzhou Medical University,Guangzhou,Guangdong,510120,China;不详)

机构地区：[1]广州医科大学附属妇女儿童医疗中心,广东广州510120

出　　处：《中国卫生质量管理》2024年第12期67-71,共5页Chinese Health Quality Management

摘　　要：目的将经中心静脉导管(CVC)采血的最佳证据应用于临床实践并评价其效果。方法遵循循证护理方法,将经CVC采血的最佳证据制订成循证实践方案,经基线审查、障碍因素分析等构建最佳证据应用策略,共总结出11条最佳证据,制订了10条质量审查指标。于2023年4月20日-8月30日在广州市某三级甲等医院小儿普外科病房实施最佳证据转化。结果证据应用后,护士对审查指标3、4、7、10的执行率均达到100.0%,其余审查指标执行率均超过85%;护士经CVC采血知识问卷得分有显著提高,证据应用前后比较差异有统计学意义(Z=-3.225,P<0.001);患儿经皮采血时疼痛评分及经CVC采血时疼痛评分的中位数及四分位数分别为8(6.5,9)分、0(0,0)分,两者比较差异有统计学意义(Z=-3.201,P<0.001)。结论将基于循证方法的经CVC采血的最佳证据应用于临床,可在一定程度上降低患儿血液标本采集时的疼痛感,提高护士对经CVC采血相关知识知晓率及执行率,规范护士经CVC采血护理行为,从而提高护理质量。Objective To apply the best evidence of blood collection through central venous catheter(CVC)to clinical practice and evaluate its effect.Methods Following the evidence-based nursing method,the best evidence of blood collection through CVC was formulated into an evidence-based practice plan.The best evidence application strategy was constructed through baseline review and obstacle factor analysis.A total of 11 best evidences were summarized and 10 quality review indicators were formulated.From April 20 to August 30,2023,the best evidence transformation was implemented in the pediatric general surgery ward of a tertiary hospital in Guangzhou.Results After the application of evidence,the implementation rates of review indicators 3,4,7 and 10 reached 100.0%by nurses,and the implementation rates of other review indicators exceeded 85%.The scores on the knowledge of blood collection through CVC among nurses were significantly improved,and the difference before and after the application of the evidence was statistically significant(Z=-3.225,P<0.001).The median and quartile of pain score at percutaneous blood collection and CVC blood collection were 8(6.5,9)and 0(0,0),respectively,and the difference was statistically significant(Z=-3.201,P<0.001).Conclusion Applying the best evidence based on evidence-based CVC blood collection to clinical practice can reduce the pain of children due to the collection of blood samples to a certain extent.It can also improve the awareness rate and implementation rate of the knowledge related to CVC blood collection among nurses,standardize the nursing behavior of nurses through CVC blood collection,so as to improve the quality of nursing.

关 键 词：中心静脉导管 采血 循证护理 护理质量 

分 类 号：R47[医药卫生—护理学]