RCA法用于儿科静脉留置针非计划拔管中的临床价值

Clinical value of RCA method in unplanned extubation of pediatric venous indwelling needle

目的：研究与探讨根本原因分析法（RC A ）用于儿科静脉留置针非计划拔管中的临床价值。方法对该院儿科2013年1～12月收治的置入静脉留置针126例患儿（对照组）实施RC A法进行回顾性分析，查找非计划拔管的原因，并制订新的护理方案后，将其应用于自2014年1～12月收治并置入留置针的130例患儿中（观察组）。比较两组患儿脱管发生率、置管费用、留置时间及儿童家长对相关信息的知晓率。结果观察组脱管发生率（3．85％）、置管费用[（53．06±6．57）元]、留置时间[（2．85±0．39）d ]低于对照组脱管发生率（29．37％）、置管费用[（176．25±23．78）元]和留置时间[（1．61±0．17）d ]，差异具有统计学意义（ P＜0．05）。观察组儿童家长对疾病相关知识知晓率（96．92％）、使用留置针过程中的注意事项知晓率（98．46％）、发生脱管的应对措施知晓率（93．85％）、如何进行有效护理知晓率（94．62％）均高于对照组（65．08％、60．32％、42．86％、49．21％），差异有统计学意义（P＜0．05）。结论 RCA法应用于儿科静脉留置针后可以在减轻患儿痛苦的同时，降低患儿家属的经济负担，临床应用价值较高。

Objective To study the clinical value of root cause analysis （RCA） in the unplanned extubation of pediatric venous indwelling needle .Methods A total of 126 children placed venous indwelling needle （control group） from January 2013 to Decem‐ber 2013 were collected ,and RCA method was carried out to analyze the unplanned extubation reasons so as to develop new nursing program .And then ,the new program was applied to 130 children placed venous indwelling needle who were selected from January 2014 until December 2014 （research group） .The incidence rates of unplanned extubation ,the costs of catheterization ,the time of in‐dwelling and the awareness rates of the knowledge in children′s parents were compared between the two groups .Results The inci‐dence rates of unplanned extubation （3 .85% ） ,the costs of catheterization [（53 .06 ± 6 .57）yuan] and the time of indwelling [（1 .61 ± 0 .17）d] in research group were significantly lower than that in control group [29 .37% ,（176 .25 ± 23 .78）yuan ,（2 .85 ± 0 .39）d]（P〈0 .05） .And the awareness rates of the disease related knowledge in parents （96 .92% ） ,matters needing attention in the use of venous indwelling needle （98 .46% ） ,response measure when the tubes fallen off （93 .85% ） and how to carry out effec‐tive nursing （29 .37% ） in research group were significantly higher than that in control group （65 .08% ,60 .32% ,42 .86% , 49 .21% ） （P〈0 .05） .Conclusion RCA method applying in the pediatric venous indwelling needle could ease the pain of the chil‐dren as well as reduce the economic burden of the parents ,which has higher clinical application value .