肿瘤患者行经外周中心静脉置管穿刺临床护理路径的应用效果分析

Application of Clinical Nursing Paths in Tumor Patients Receiving PICC

目的对比分析肿瘤患者行经外周中心静脉置管(PICC)穿刺应用临床护理路径(CNP)的护理模式与常规健康教育和护理方法的效果差异。方法抽取留置PICC的肿瘤患者按照住院的先后顺序将其编号,单号为观察组(n=105),双号为对照组(n=105)。观察组应用CNP的护理模式,对照组采用常规健康教育和护理方法。观察两组患者PICC并发症发生率,并在出院前对两组患者进行满意率及健康教育达标率调查。结果观察组发生穿刺处渗血5例、机械性静脉炎4例、PICC堵塞3例、导管相关性感染2例、PICC脱出1例;对照组分别为12、10、8、6、6例;两组并发症发生率间差异有统计学意义(χ2=16.2779,P<0.05)。对照组患者满意率为74.3%(78/105)、观察组患者满意率为96.2%(101/105);对照组健康教育达标率71.4%(75/105)、观察组健康教育达标率为91.4%(96/105);两组满意率和健康教育达标率间差异均有统计学意义(χ2分别为18.3168和12.5956,P<0.05)。结论对行PICC穿刺的肿瘤患者进行护理时,将CNP应用于临床工作中,使护理人员尽早发现并发症,并尽快采取护理措施,可减少并发症发生率,提高患者满意率和健康教育达标率,而且减少了患者的痛苦、有效地改善了护患关系、创造了良好的社会效益,也实现了医院优质、高效、低耗的目标管理。

Objective To compare the effect of clinical nursing paths （CNP） with that of standard nursing methods in tumor patients receiving peripherally inserted central catheter （PICC）. Methods Patients receiving PICC were divided accord- ing to hospitalizing order into groups observation （odd numbers, n = 105, receiving CNP） and control （even numbers, n =105, receiving standard nursing method）. Incidence of P1CC complications were observed and rates of satisfaction and health ed- ucation standard - achieving investigated in two groups before discharge. Results In observation group, 5 had bleeding on puncture sites, 4 mechanical phlebitis, 3 PICC occlusion, 2 catheter- related infection, 1 PICC prolapse; in control group were12, 10, 8, 6, 6 ; the difference was significant （ χ2 = 16. 2779, P 〈 0. 05）. The rates of satisfaction and health educa- tion standard - achieving were 74. 3% （78/105）, 71.4% （75/105） in control group; And in observation group were 96. 2% （ 101/105）, 91.4% （96/105）, the difference was significant （χ2 = 18. 3168, 12. 5956, respectively, P 〈0. 05）. Conclu- sion CNP used in tumor patients undergoing PICC can find complications earlier and take nursing measures as soon as possible, reduce complication incidence, improve patients＇ rates of satisfaction and health education standard- achieving, decrease pa- tients＇ pains, improve the nurse- patient relationship, obtain good social benefits and realize high- quality, high- effect and low -consumption management by objectives.