环节质量控制预防乳腺癌患者PICC导管相关血流感染的效果分析

Effect analysis on step quality control in the prevention of PICC catheter-related bloodstream infection in breast cancer patients

目的对乳腺癌患者PICC维护环节的质量监控，提高PICC导管的维护质量，以预防导管相关性血流感染（CRBSI）。方法2013年7月-2015年12月通过制定预防CRBSI方案，组织对护理人员操作规程培训．与医院感染控制办共同实施对PICC导管维护环节的质量监控、反馈、评估、干预，持续改进维护环节的质量，通过监测PICC导管维护环节质量的合格率，评估环节质量的改进对预防CRBSI的效果。结果通过对方案实施，监控不同阶段维护环节质量，环节质量合格率提高；监控乳腺癌留置PICC管患者的CRBSI发生率由3．27％下降至0．62％，由2．5666／千例导管日下降至0．0618／千例导管日，差异有统计学意义（X2=2．477，P〈0．01）。结论通过监控PICC导管维护环节质量可以有效降低CRBSI发病率。

Objective To observe the quality control in peripherally inserted central catheter （PICC） in patients with breast cancer, and improve the maintenance quality of PICC catheter in order to prevent PICC catheter-related bloodstream infection （CRBSI）. Methods From July 2013 to December 2015, nursing staff received operating training according to the scheme for the prevention of CRBSI. Quality control, feedback, evaluation and intervention were used by the office of nosoeomial infection control to monitor the maintenance step of PICC catheter and continuously improve the quality of maintenance step. The effect of improving step quality in the prevention of CRBSI was evaluated by monitoring the qualification rate of PICC catheter maintenance step. Results The qualified rate of PICC was increased through the implementation of scheme and maintenance of step quality in various stages; the incidence of CRBSI among breast cancers patients with PICC declined from 3.27% （2.566 6/1 000 catheter · day） to 0.62% （0.061 8/ 1 000 catheter · day） （ X2 = 2.477, P 〈 0. 01 ）. Conclusions Monitoring the step quality of PICC catheter maintenance can contribute to the decline of the incidence of CRBSI.