持续质量改进对肿瘤患者经外周静脉置入中心静脉导管相关血流感染的影响

Impact of continuous quality improvement on peripherally inserted central catheter-related bloodstream infectious for cancer patients

目的探讨持续质量改进（CQI）方法对肿瘤患者经外周静脉置入中心静脉导管（PICC）的导管相关血流感染（CRBSI）的影响。方法选择本院CQI前（2007年6月～12月）51例肿瘤患者，分析PICC置管后CRBSI的发生情况，采用计划、实施、检查、应用（PDCA）四步法，设计并实施改善留置PICC的肿瘤患者CRBSI的防护措施，与CQI后次年同期（2008年6月－12月）99例留置PICC的肿瘤患者CRBSI发生情况进行比较。结果CQI后，PICC置管CRBSI发生率由2．57例次／1000导管留置日明显降至0．68例次／1000导管留置日，较CQI前降低了73％（P〈0．05）。结论CQI方法可以有效降低肿瘤患者PICC置管的CRBSI。

Objective To study the impact of continuous quality improvement （CQI） program for the control of catheter-related bloodstream infections （CRBSI） on cancer patients with peripherally inserted central＇ catheter （PICC）. Methods We first analyzed CRBSI incidence in 51 cancer patients with PICC recruited before the implementation of CQI. Then CQI was carried out for the prevention of CRBSI. The procedures of CQI included four steps： plan, do, check, and action （PDCA）. We then recruited 99 cancer patients with PICC receiving CQI, and compared the CRBSI incidence of these 99 patients with that of the 51 patients without CQL Results CRBSI incidence decreased from 2.57 times/1 000 catheterization days in patients without CQI to 0. 68 times/1 000 catheterization days in those receiving CQI （ P 〈 0. 05 ）. Conclusion CQI program effectively reduces CRBSI incidence in cancer patients with PICC.