置管前经外周静脉穿刺置入中心静脉导管并发症风险评估指标体系的构建

Establishment of a risk assessment index system for peripherally inserted central catheterization complications before placement

目的构建适用于临床的置管前经外周静脉穿刺置入中心静脉导管(peripherally inserted central catheterization,PICC)患者并发症风险评估指标体系,用于医护人员在PICC置管前对患者的情况进行系统评估,判断相关并发症发生的可能性。方法通过前期对PICC置管专业护士进行问卷调查、专家访谈、文献查证和Meta分析,形成置管前PICC并发症风险评估指标体系,采用改良德尔菲法对18位PICC护理专家进行咨询和重要性评分,用Excel 2015和SPSS 21.0软件计算指标权重并修改定稿。结果依据PICC并发症的相关风险因素,建立了由4个一级指标和41个二级指标组成的置管前PICC并发症风险评估指标体系,其中一级指标包括患者基本情况(16个二级指标)、穿刺肢体情况(12个二级指标)、血管和导管选择情况(8个二级指标)和患者依从性(5个二级指标)。结论初步建立了置管前PICC并发症风险评估指标体系,能据此进行PICC并发症风险评估,从而针对性制定护理计划以预防和减少PICC并发症的发生。

Objective To establish a risk assessment index system of peripherally inserted central catheterization（ PICC） complications,and provide a scientific basis for risk assessments before placing PICC.Methods Preliminary framework and indicators were formulated based on literature review,Meta analysis,conversation and questionnaire. By Delphi approach,the risk assessment indexes were made into table questionnaire,and expert consultation was conducted. Importance of the risk assessment indexes were scored.Weights were determined by Excel 2015 and SPSS 21. 0. Results A preliminary PICC complication risk assessment index system including 4 first-class indexes and 41 secondary-class indexes was established based on the main factors of PICC complications. The first-class indicators included basic situation of patients（ 16 secondary indicators）,inserted body condition（ 12 secondary indicators）,vessel and catheter selection（ 8 secondary indicators） and patient compliance（ 5 secondary indicators）. Conclusion The risk assessment index system of PICC complications before placement is basically established to assess the complication risk,so as to prevent and reduce the incidence of PICC complications.