P DCA护理管理在老年恶性肿瘤患者P ICC置管中的应用效果

Application of PDCA nursing management in central venous catheter of elderly patients with malignant tumor patients

目的：探讨PDCA护理管理在老年恶性肿瘤患者PICC相关感染中的应用。方法2014年1月—2015年12月选取收治的120例老年肿瘤PICC患者为研究对象,根据患者入院时间分为观察组（2015年1—12月,n＝60）及对照组（2014年1—12月,n＝60）,观察组置管期间应用PDCA护理管理,对照组置管期间应用常规性护理管理,比较两组PICC相关性感染、不良护理事件发生情况、护理效果。结果观察组PICC相关感染、机械性静脉炎、非计划性拔管发生率、导管滑脱率、导管堵塞发生率低于对照组（P〈0.05）。观察组置管依从性、一次性穿刺成功率、满意率高于对照组（P〈0.05）,留置导管时间长于对照组（ P〈0.05）。观察组对护士沟通能力、责任心、PICC操作技能、服务态度、书写规范性、PICC意外事件等护理质量方面评分高于对照组（P〈0.05）。结论 PDCA护理管理能有效提高老年恶性肿瘤PICC患者护理质量,降低患者 PICC相关感染及护理意外事件,延长患者留置导管时间,提高患者满意度。

Objective To explore the application of PDCA nursing management in central venous catheter of elderly patients with malignant tumor patients.Methods Totally 120 cases of elderly cancer patients with PICC were divided into the observation group （ from January 2015 to December 2015, n=60） and the control group （ from January 2014 to December 2014, n=60） according to the time of admission from January 2014 to December 2015. Patients in the observation group were given PDCA nursing management, while patients in the control group were given routine nursing management. The PICC related infections, adverse nursing events occurrence and the nursing effect of two groups were compared.Results The PICC related infection, mechanical phlebitis, unplanned extubation rate, catheter slippage rate and catheter blockage rate of the observation group were lower than those of the control group （P〈0.05）. The compliance, the success rate of one-time puncture and the satisfaction rate of the observation group were higher than those of the control group （P〈0.05）; the indwelling catheter time was longer than the control group （ P〈0. 05 ） . The nurse communication ability, responsibility, PICC operation skills, service attitude, writing standards, PICC accident and other nursing quality score in the observation group were higher than the control group （ P〈0. 05）. Conclusions PDCA nursing management can effectively improve the nursing quality of elderly patients with malignant tumor who had PICC;reduce the PICC related infections and nursing accidents; prolong the time of indwelling catheter in patients;and improve the patient′s satisfaction rate.