循环质控理念指导下风险预控在预防经外周置入中心静脉导管置管患者导管相关性血流感染中的应用价值

Application Value of Risk pre Control under the Guidance of Circulation Quality Control Concept in Preventing Catheter-related Bloodstream Infections in Patients with PICC Catheterization

目的探讨循环质控理念指导下风险预控在预防经外周静脉置入中心静脉导管(PICC)置管患者导管相关性血流感染(CRBSI)中的应用价值。方法选取2020年6月至2022年7月在上饶市第二人民医院行PICC置管术的患者78例作为研究对象,以2020年6月至2021年6月(风险预控小组成立前)收治的39例患者为对照组,采用常规护理干预,以2021年7月至2022年7月(风险预控小组成立后)收治的39例患者为观察组,在循环质控理念下实施护理干预。比较两组患者置管相关指标、CRBSI发生情况、健康状况调查问卷(SF-36)各维度评分、治疗依从性以及满意度。结果观察组PICC置管首次穿刺成功时间短于对照组,置管时间长于对照组,PICC管理方式及技术认可度评分均高于对照组,差异有统计学意义(P<0.05);观察组CRBSI发生率低于对照组(P<0.05);干预后两组生理功能、生理职能、躯体疼痛、总体健康、精力、社会职能、精神健康、情感职能评分均有所升高,且观察组均高于对照组,差异有统计学意义(P<0.05);观察组依从性、满意度高于对照组(P<0.05)。结论循环质控理念指导下风险预控可使PICC患者CRBSI发生率降低,延长导管留置时间,效果显著。

Objective To explore the effect of risk pre control under the guidance of circulation quality control concept in the prevention of catheter related bloodstream infection(CRBSI)in patients with Central venous catheter(PICC)placement in peripheral vein.Methods A total of 78 patients undergoing PICC cathedralization in Shangrao Second People's Hospital from June 2020 to July 2022 were selected as the study objects,and 39 patients admitted from June 2020 to June 2021(before the establishment of risk pre-control group)were selected as the control group,and routine nursing intervention was adopted.Thirty-nine patients admitted from July 2021 to July 2022(after the establishment of the risk pre-control group)were selected as the observation group,and nursing intervention was implemented under the concept of cyclic quality control.Catheter-related indicators,incidence of CRBSI,health status questionnaire(SF-36)scores,treatment compliance and satisfaction were compared between the two groups.Results The first successful time of PICC catheterization in the observation group was shorter than that in the control group,and the catheterization time was longer than that in the control group,and the scores of PICC management style and technical recognition were higher than those in the control group,with statistical significance(P<0.05).The incidence of CRBSI in observation group was lower than that in control group(P<0.05).After intervention,the scores of physiological function,physiological function,physical pain,general health,energy,social function,mental health and emotional function were increased in both groups,and the observation group was higher than the control group,the difference was statistically significant(P<0.05).The compliance and satisfaction of observation group were higher than those of control group(P<0.05).Conclusion Under the guidance of the concept of cyclic quality control,risk pre control can reduce the incidence of catheter related bloodstream infections and prolong the catheter retention time in the prevention of CRBSI in PICC patients,with significant results.