个案管理模式在PICC带管出院肿瘤患者延续护理中的运用

Application of case management mode in the transitional care of tumor patients discharged from hospital with PICC

目的探讨个案管理模式在经外周置入的中心静脉导管(PICC)带管出院肿瘤患者延续护理中的应用及效果。方法选取2018年1月~2019年1月我院收治的216例新置入PICC导管的肿瘤患者作为研究对象,按照随机数字表法分为实验组(n=108)与对照组(n=108)。对照组采用常规性延续护理,实验组实施个案管理。比较两组PICC留置时间、非计划性拔管率、按时维护依从性及PICC相关并发症的发生情况。结果实验组并发症总发生率、非计划性拔管率低于对照组,按时维护依从性高于对照组,差异均有统计学意义(P<0.05)。实验组的PICC留置时间长于对照组,差异无统计学意义(P>0.05)。结论个案管理模式可为PICC带管出院肿瘤患者提供全程、高质量的延续护理,提高患者导管维护依从性、降低导管相关性并发症的发生率,延长PICC的留置时间,值得临床推广应用。

Objective To explore the application and effect of case management mode in the transitional care of tumor patients discharged from hospital with peripherally inserted central catheter(PICC).Methods A total of 216 patients with newly inserted PICC catheters who were admitted to our hospital from January 2018 to January 2019 were selected as the study subjects.According to the random number table method,the patients were divided into experimental group(n=108)and control group(n=108).The control group received routine continuous nursing.The experimental group implemented case management.The duration of PICC,the rate of unplanned extubation,the compliance of timely maintenance and the complications of PICC were compared between the two groups.Results The total incidence of complications and unplanned extubation in the experimental group were lower than those in the control group,and the compliance of timely maintenance was higher than that in the control group,the differences were statistically significant(P<0.05).The duration of PICC in the experimental group was longer than that in the control group,the difference was not statistically significant(P>0.05).Conclusion The case management mode can provide the whole course and high quality continuous nursing for the patients with PICC discharged from the hospital,improve the compliance of patients′catheter maintenance,reduce the incidence of catheter-related complications,and prolong the retention time of PICC,which is worthy of clinical application.