儿童血管通路专业组的建立与实践

Establishment and practice of a dedicated vascular access team in pediatric care

目的探讨儿童血管通路专业组的建立对血管通路并发症的影响。方法建立儿童血管通路专业组,进行血管通路知识培训,负责进行血管通路相关问题会诊,建立外周静脉留置针核查表并根据核查结果决定是否保留留置针。收集专业组建立10个月的全院血管通路并发症的发生情况。结果 2016年9月到2017年6月外周静脉留置导管的187 787例日数中的并发症发生率为0.19/1 000置管日,中心静脉导管的8 988例日数中并发症发生率为0.67/1 000置管日,PICC的17 038例日数中并发症发生率为1.47/1 000置管日,静脉输液港置管2 050例日数,并发症为0。全院会诊35例次。结论儿童血管通路专业组的建立可保障血管通路成功建立与维护,减少血管通路相关并发症,促进儿童康复。

Objective To explore the effect of a dedicated vascular access team on prevention of catheter-associated complications in pediatric care. Methods We built a dedicated vascular access team for pediatric patients and provided training for members of the team, then they were asked to provide consultations for solving vascular access problems and developed a checklist of peripheral ve- nous indwelling catheter for clinical nurses to determine whether there is a need to keep the catheter. Catheter-associated complica- tions were collected after 10 months of the practice. Results From September 2016 to June 2017, the total number of indwelling catheter days was 187 787 for peripheral venous catheters, 8 988 for central venous catheters, 17 038 for peripherally inserted cen- tral catheters, and 2 050 for implanted venous ports. And the incidence of complications was 0.9/1 000, 0.67/1 000, 1.47/1 000, and 0 indwelling catheter days, respectively. The team provided 35 counts of consultations. Conclusion Establishment of a dedicated vascular access team in pediatric care guarantees successful placement and maintanence of vascular access and reduces complica- tions, thus to promote children＇s recovery.