品管圈对降低经外周置入中心静脉导管置管患者感染的效果研究

Effect of quality control circle on reduction of incidence of infection in patients undergoing peripherally inserted central catheter intubation

目的研究分析品管圈对经外周置入中心静脉导管(PICC)置管术后降低导管感染率的效果,为预防置管感染提供依据。方法选择2011年6月-2015年6月住院治疗需行PICC置管的患者256例作为研究对象,将2011年6月-2013年6月的128例患者作为对照组,给予常规护理干预措施;将2013年7月-2015年6月的128例患者作为观察组,给予品管圈护理模式;分析PICC置管术后的导管感染病原菌分布,对比两组不同时期PICC置管术后的导管感染率、干预前后护理人员的工作评分。结果 22例发生PICC置管术后导管感染者共检出27株病原菌,革兰阳性菌13株占48.15%,革兰阴性菌10株占37.04%,真菌4株占14.81%;观察组干预后7d的感染率及总感染率分别为2.34%及3.13%,显著低于对照组的8.59%及14.06%,差异有统计学意义(P<0.05);干预后观察组护理人员工作评分显著高于对照组,差异有统计学意义(P<0.05)。结论品管圈护理对PICC置管术后导管感染率具有降低作用,值得推荐。

OBJECTIVE To observe the effect of quality control circle on reduction of the infection rate in the patients undergoing peripherally inserted central catheter（PICC）intubation so as to provide guidance for prevention of catheter-related infections.METHODS A total of 256 hospitalized patients who needed to receive the PICC intubation from Jun 2011 to Jun 2015 were recruited as the study objects,128 patients who underwent the PICC intubation from Jun 2011 to Jun 2013 were assigned as the control group,and 128 patients who underwent the PICC intubation from Jul 2013 to Jun 2015 were set as the observation group.The control group was treated with conventional nursing interventions,while the observation group was given the quality control circle nursing mode.The distribution of the pathogens causing the PICC-related infections was observed,and the incidence of the catheterrelated infections and the work score of nursing staff were compared between the two groups in the different periods.RESULTS Totally 27 strains of pathogens were isolated from 22 patients with the catheter-related infections after the PICC intubation,including 13（48.15%）strains of gram-positive bacteria,10（37.04%）strains of gram-negative bacteria,and 4（14.81%）strains of fungi.The infection rate of the observation group was 2.34%after the intervention for 7days,significantly lower than 8.59% of the control group;the total infection rate of the observation group was 3.13%,significantly lower than 14.06% of the control group（P〈0.05）.The work scores of the nursing staff were significantly higher in the observation group than in the control group after the intervention after the intervention（P〈0.05）.CONCLUSIONThe quality control circle shows an effect on reduction of incidence of the catheter-related infections after the PICC intubation,and it is worthy to be promoted.