多准则决策分析法构建集束干预策略预防中心静脉导管相关性感染的效果

Effect of Multi-criteria Decision Analysis to Construct Bundle Intervention Strategy in Prevention of Central Venous Catheter-related Infection

目的探讨运用多准则决策分析法构建集束干预策略对中心静脉导管相关性感染(central venous catheters-related infections,CVC-RI)的预防效果。方法将2009年1月至2011年7月在湖南医药学院附属怀化市第一人民医院住院的98例行中心静脉置管的老年患者作为对照组,进行回顾性分析,了解CVC-RI发生率及病原菌分布情况;将2012年4月至2013年10月的102例患者作为干预组,运用多准则决策分析法构建集束化干预策略并将其运用于治疗护理中。比较两组患者CVC-RI的发生率。结果对照组和干预组发生导管相关血流感染(catheter related blood stream infection,CRBSI)者分别为16例(16.33%)和5例(4.90%),感染率分别为12.09例/千导管日和4.07例/千导管日,差异均有统计学意义(P<0.05);干预组局部感染发生率[3.92%(4/102)]低于对照组[13.27%(13/98)],差异有统计学意义(P=0.018)。结论将采用多准则决策分析法构建的集束干预策略应用于行中心静脉置管的老年患者,能有效减少穿刺处病原菌侵入、降低CVC-RI的发生率。

Objective To determine the effect of multi-criteria decision analysis to construct bundle intervention strategy in prevention of central venous catheter-related infection.Methods Ninety-eight elderly patients with cen- tral venous eatheters（CVCs） from January 2009 to July 2011 were selected as control group,and use retrospective analysis to analyze the incidence rate of CVC-RI and pathogenic bacteria distribution.102 elderly patients from April 2012 to October 2013 were selected as intervention group,and use multi-criteria decision analysis to construct bundle intervention strategy in the treatment and nursing.The incidence of CVC-RI was compared between two groups of patients.Results The incidences rate of catheter related blood stream infection in control group and intervention group were 16 cases （16.33%） and 5 cases （4.90%）,and the infection rate was 12.09 cases/1000 catheter days and 4.07/1000 catheter days （P〈0.05）.The incidence of local infection in the control group was [13.27% （13/98）], while it was [3.92%（4/102）] in the intervention group（P=0.018）.Conclusion Applying multi-criteria decision analysis to construct bundle intervention strategy in elderly patients can reduce pathogens invasion in puncture site and the incidence of CVC-RI.