早产儿经PICC进行肠外营养的持续质量改进效果观察

Effects of nursing team management of parenteral nutrition with PICC in preterm infants

目的:分析护理质量改进在经PICC进行肠外营养早产儿护理管理中的效果。方法:选择2013年1月至2018年12月在某三级甲等医院新生儿重症监护病房经PICC进行肠外营养的507例早产儿为研究对象,其中2013年1月至2015年12月收治的240例早产儿作为对照组,给予常规护理;2016年1月至2018年12月收治的267例早产儿作为观察组,实施改进后的护理措施。比较两组患儿在经PICC进行肠外营养期间,导管留置时间及相关并发症的发生情况。结果:观察组导管留置时间[19(12,29)d]长于对照组[16(11,22)d],具有统计学差异(Z=-2.947,P=0.003)。观察组发生PICC导管相关并发症发生率(2.25%)低于对照组(9.58%),具有统计学差异(χ^2=13.651,P<0.001)。结论:建立PICC专业管理小组,细化置管关键环节,加强感控管理等措施,可明显减少早产儿PICC导管相关并发症发生,延长导管使用时间,并有效提升早产儿肠外营养质量。

Objective:To study the effect of nursing team management in parenteral nutrition management of preterm infants via PICC.Methods:A total of 507 preterm infants who underwent parenteral nutrition using PICC in the neonatal intensive care unit of one Children’s Hospital in Beijing were selected as the subjects.Totally 240 premature infants admitted from January 2013 to December 2015 were included in the control group and implemented with routine care.The 267 premature infants admitted from January 2016 to December 2018 were included in the observation group and performed team nursing management.The incidence of PICC catheter-related complications were compared between the two groups.Results:The median catheter indwelling time(19 days)in the observation group was significantly longer than the control group(16 days)(Z=-2.947,P=0.003).The incidence of PICC catheter complications in the observation group(2.25%)was significantly lower than the control group(9.58%)(χ~2=13.651,P<0.001).Conclusion:Team management of the nutrition of the premature infants with PICC can reduce the incidence of PICC catheter-related complications and improve the quality of life in preterm infants.