根本原因分析法在预防PICC静脉内导管断裂中的应用

Application of root cause analysis in preventing PICC venous catheter fracture

目的探讨根本原因分析法在预防PICC静脉内导管断裂中的应用与效果。方法应用根本原因分析法找出PICC静脉内导管断裂的根本原因,有针对性地制订并实施细化PICC置管流程、加强PICC维护培训及患者健康教育、实施院外PICC追踪服务等。结果应用根本原因分析法后,PICC静脉内导管断裂未再发生。结论运用根本原因分析法可有效预防PICC静脉内导管断裂,是PICC安全管理的有效方法。

Objective To explore the application and effects of root cause analysis （RCA） in preventing peripherally inserted central catheter （PICC） venous catheter fracture, Methods The root causes of PICC venous catheter fracture were found out using RCA. The improvement measures were implemented, including detailing the process of indwelling PICC, strengthening the training of maintaining PICC for nurses and patients, and delivering PICC tracing service after discharge. Result After implementation RCA, PICC venous catheter fracture was never happened again. Conclusion The use of RCA can effectively prevent PICC venous catheter fracture,which is an effective method of PICC safety management.