同质化管理在血液透析患者中心静脉导管护理的应用效果

Application effect of homogenization management in central venous catheter nursing of hemodialysis patients

目的:探讨同质化管理在血液透析患者中心静脉导管(Central Venous Catheter,CVC)护理的应用效果。方法:选取重庆市中医院2018年2月-2020年1月住院及门诊行维持性血液透析患者采用CVC作为血透通路。将2018年2月-2019年1月用中心静脉导管作为透析通路的患者作为对照组,采用同质化管理后的2019年2月-2020年1月用中心静脉导管作为透析通路的患者作为观察组。对照组采用优质护理模式,参照《血液透析专科护理操作指南(2014年版)》的CVC使用护理常规方法。观察组在优质护理的基础上采用同质化管理模式,成立同质化管理小组,小组通过临床实践,对CVC护理操作流程进行再细化。加强对护理操作步骤、方法、时间的规范化、标准化、科学化。并对护理人员进行培训考核。对临床护理工作开展实施督导,定期反馈。并分类整理,分项检查,采取改进措施。结果:比较两组患者的导管感染率、导管失功率、患者满意度。差异均有统计学意义(P<0.05),观察组优于对照组。结论:同质化管理模式提高了血液透析患者CVC的护理质量,减少导管并发症,提高了患者满意度,值得临床推广应用。

Objective:To investigate the effect of homogenization management on hemodialysis patients with Central Venous Catheter.Methods:CVC was used for hemodialysis in Chongqing Traditional Chinese Medicine Hospital from February 2018 to January 2020.Patients with Central Venous Catheter as dialysis access from February 2018 to January 2019 were selected as the control group,and patients with Central Venous Catheter as dialysis access from February 2019 to January 2020 after homogenization were selected as the observation group.The control group was treated with high quality nursing model and CVC nursing routine method according to the 2014 edition of the Special Nursing Operation Guide for hemodialysis patients.On the basis of high-quality nursing care,the observation group received the homogeneity management model and set up the homogeneity management group.The standardization,normalization and scientification of nursing procedures,methods and time were strengthened.And the training appraisal to the nursing staff was carried out in addition to supervision and regular feedback on clinical nursing work.And the management was sorted out separately,checked item by item to take improvement measure.Results:The infection rate of catheter,the power loss rate of catheter and patient satisfaction were compared between the two groups.The difference was statistically significant(P<0.05),the observation group was better than the control group.Conclusion:The homogeneity management mode can improve the nursing quality of hemodialysis patients with CVC,reduce catheter complications,improve patient satisfaction,and it is worthy of clinical application.