PDCA循环质量控制模式在新生儿经外周静脉置入中心静脉导管术中的应用效果

Effect of PDCA Circulation Quality Control Mode in Neonatal Central Venous Catheterization via Peripheral Vein

目的探讨PDCA循环质量控制模式在新生儿经外周静脉置入中心静脉导管(PICC)术中的应用效果,以期为新生儿的输液护理提供参考。方法选取2019年3月至2020年4月阳谷县人民医院收治的采取PICC术的88例极低或超低出生体质量患儿作为研究对象。按照入院先后顺序将其分为对照组和观察组,每组44例。对照组采用普通PICC置管后护理方法,观察组在对照组基础上采用PDCA护理控制模式。比较两组患儿非计划拔管率、导管留置时间及护理效果。结果观察组患儿非计划拔管率为20.45%,显著低于对照组的86.36%,差异有统计学意义(χ^2=17.2874,P<0.05)。观察组导管留置时间为(25.36±3.15)d,对照组为(21.42±3.78)d,差异有统计学意义(t=7.482,P<0.05);观察组家长满意度评分为(95.38±2.39)分,对照组为(84.56±2.87)分,差异有统计学意义(t=9.025,P<0.05)。结论使用PDCA循环质量控制模式干预采取PICC术的极低或超低出生体质量患儿,可显著延长PICC导管留置时间,降低堵塞、异位、静脉炎等非计划拔管率,家长满意度较高。

Objective To investigate the effect of PDCA circulation quality control mode in the peripherally inserted central venous catheter of newborn,and to provide reference for transfusion nursing of newborn.Methods From March 2019 to April 2020,88 cases of very low and ultra-low birth weight infants admitted and underwent PICC catheterization were selected as the subjects of this study.According to the sequence of admission,the patients were divided into control group and observation group,with 44 cases in each group.The control group adopted the general nursing method after PICC,while the observation group adopted PDCA nursing control mode on the basis of the control group.The rate of unplanned extubation was compared between the two groups.The lower the unplanned extubation rate,the longer the catheter stay time,indicating the better the nursing effect.Results The unplanned extubation rate in the control group was 86.36%,which was significantly higher than that in the observation group(20.45%),the difference was statistically significant(χ^2=17.2874,P<0.05).The catheter retention time of the observation group was(25.36±3.15)d,and that of the control group was(21.42±3.78)d,the difference was statistically significant(t=7.482,P<0.05).The parental satisfaction score of the observation group was(95.38±2.39)score,and that of the control group was(84.56±2.87)score,the difference was statistically significant(t=9.025,P<0.05).Conclusion Using PDCA circulation quality control mode,the indwelling time of PICC catheter can be prolonged,and the complications such as blockage,heterotopia and phlebitis can be significantly reduced,which has higher satisfaction.