肿瘤患儿PICC局部感染的循证护理实践

Evidence-based nursing practice of PICC local infection in pediatric patients with tumors

目的：应用循证护理的方法获取和运用最佳证据，探索肿瘤患儿PICC局部感染的有效护理干预方法。方法根据肿瘤患儿PICC局部感染的判定和程度划分标准和临床护理措施提出问题，采用电子检索和图书馆手动检索相关证据。结果检索出PICC局部感染的判定和程度划分标准和护理措施的相关证据，通过证据评价，结合本专科临床现状和患者意愿，形成本专科PICC局部感染的判定和程度划分标准以及相应护理措施，对专科32例肿瘤患儿的PICC局部感染根据感染程度采用针对性护理措施，效果良好，无一例患儿因为PICC局部感染导致化疗延迟或非计划性拔管。结论应用循证护理的方法可以有效解决临床护理工作中常见的护理问题，提升护理人员获取和运用最佳证据的能力，促进护理工作的科学性和有效性。

Objective To develop an effective nursing intervention for PICC local infection in pediatric patients with tumors based on the best evidence obtained by methods of evidence-based nursing. Methods Questions were raised regarding the diagnosis and grading of PICC local infection in pediatric patients with tumors and the implementation of corresponding clinical care. Relevant literature evidence was reviewed using both electronic and manual library search. Results Relevant literature evidence about the diagnosis and grading of PICC local infection in pediatric patients with tumors and corresponding clinical care was identified, followed by a critical appraisal process. The criteria, used in our department, for diagnosis and grading of PICC local infection in pediatric patients with tumors and corresponding clinical care measures were formulated according to relevant evidence, current clinical status of our department and willingness of patients. Thereafter, corresponding clinical care measures were applied to 32 tumor pediatric patients with PICC local infection in our department according to the grading of infection. Good therapeutic effect was achieved and PICC local infection did not lead to chemotherapy delay or unplanned extubation in any pediatric patient. Conclusions The approach of evidence-based nursing can be used to effectively resolve common nursing problems in clinical practice, promote the ability of nursing staff to obtain and apply the best evidence and promote the scientificity and validity of nursing practice.