居家留置PICC成年患者安全评估工具的研制

The development of safety assessment tool for adult patients with Peripherally Inserted Central Catheters at home

目的 :研制适用于评价居家留置PICC成年患者导管安全性的量化工具。方法 :以2011版美国静脉输液护士学会(Intravenous Nurses Society,INS)的输液治疗护理实践标准为指导,采取德尔菲(Delphi)专家咨询法和面对面患者访谈研究法,确认患者携PICC管居家期间发生并发症的主观感受,最终确定居家留置PICC成年患者评估工具。结果 :3轮咨询的专家积极系数分别为88.9%、100.0%与94.4%,专家权威系数为0.89,成年患者留置PICC居家自我感受量表的Cronbach’sα系数是0.83,包括疼痛、皮肤改变、局部渗血、导管移位、手臂肿胀、活动受限、导管破损、主观症状、体温异常9个一级指标,一级指标的Cronbach’sα系数均>0.70,Kendall协调系数(W)显著性检验均具有统计学意义(P<0.001)。结论 :本研究结果可靠、准确,所研制的评估工具可实现居家与住院之间PICC导管的无缝链接观察,可作为居家留置PICC成年患者的评估工具。

Objective：To develop a quantitative evaluation tool for assessing safety of catheters in adults with indwelling PICC at home.Methods：Delphi expert consultation and face to face interviews with patients were used under the guidence of nursing practice standards of infusion treatment of Intravenous Nurses Society（INS）（2011 th Edition）,in order to develop and establish an assessment tool to record and assess patients＇ subjective perceptions about occurance of complications related to PICC at home.Results：Expert positive coefficient of three rounds of expert consultation was 88.9%,100% and 94.4%,respectively.The expert authority coefficient was 0.89.The Cronbach alpha coefficient of Self Perception Scale of Adult Patients with PICC at Home was 0.83,including 9 first-level indicators,such as pain,skin ulceration,local bleeding,catheter displacement,arm swelling,limitation of activity,catheter damage,subjective symptoms and abnormal temperature,whose Cronbach alpha coefficient was all beyond 0.70.Kendall coordination coefficient（W） significant test was statistically significant（P〈0.001）.Conclusion：This study was reliable and accurate.The assessment tool established could be used for transitional observation of PICC catheters between home and hospital.It can be used as an assessment tool for PICC patients in the home.