急诊重症监护病房导管相关血行感染控制的行动研究

Action research of catheter related bloodstream infection control in the emergency intensive care unit

目的 探讨急诊重症护理实践中,在危重症患者导管感染控制方面存在的问题,降低导管相关血行感染（CRBSI）的发生率.方法 采用行动研究的方法,在识别EICU导管相关血行感染的发生率较高的问题后,按照＂计划—行动—观察—反思＂的循环过程,依次对EICU医护人员进行知识—态度—行为的调查,征询急危重症医护专家的意见来确定预防措施,改善导管相关感染控制的临床实践,控制CRBSI的发生率.结果 19名医护人员组成了行动小组,2015年6—7月第1轮循环后CRBSI发生率为12.12‰,2015年8—9月第2轮循环后CRBSI的发生率下降至8.90‰.Logistic回归分析显示,导管留置时间及性别影响了CRBSI的发生.结论 行动研究法在降低CRBSI发生率的研究中,不断改善急诊重症病房中导管相关感染的临床护理实践,值得在重症护理领域尝试.

ObjectiveTo analyze the problems in the catheter related bloodstream infection （CRBSI） control for critically ill patients to reduce the incidence of CRBSI in emergency nursing practice.Methods An action research was performed to identify the problems causing high occurrence rate of CRBSI in emergency intensive care unit （EICU）. According to the process of ＂plan-action-observation-reflection＂,doctors and nurses were surveyed on the knowledge-attitude-action successively. The preventive measures were determined in accordance with advices of emergency medical care specialist to improve the clinical practice of CRBSI control and control the incidence of CRBSI.Results An action group containing 19 EICU medical workers was built up. After the first round from June to July 2015,the incidence rate of CRBSI was 12.12‰. After the second round from August to September 2015,the incidence rate of CRBSI decreased to 8.90‰. Logistic regression analysis showed that the ductal indwelling time and gender of patients affected the occurrence of CRBSI.Conclusions In the study of decreasing the incidence of CRBSI,action research can improve the clinical nursing practice of CRBSI in EICU and is worth trying in the field of intensive care.