基于目标管理理论的干预策略在预防患者中心血管导管相关血流感染中的应用

Application effect of target management theory-based intervention strategy in preventing Central Line Associated Blood Stream Infection

目的:评价基于目标管理理论的干预策略在预防呼吸内科ICU患者中心血管导管相关血流感染(CLABSI)中的应用效果。方法:选取某三级甲等医院2019年1月1日至2020年12月31日在呼吸内科ICU留置中心静脉血管通路装置的患者作为研究对象,2019年1月1日至12月31日的患者为对照组,接受常规护理,2020年1月1日至12月31日的患者为干预组,在对照组基础上进行基于目标管理理论的针对性干预。比较两组患者CLABSI发生情况、PICC和CVC置管的感染情况及防控措施的执行情况。结果:共纳入患者256例,9例发生CLABSI,CLABSI发生率为4.889例次/千导管日,例次感染率为4.02%。对照组CLABSI发生率为8.917例次/千导管日,干预组为1.894例次/千导管日。两组CLABSI发生率比较,差异有统计学意义(P=0.043)。两组PICC置管的CLABSI发生率与CVC置管的CLABSI发生率相比,差异有统计学意义(P=0.028)。结论:基于目标管理理论的干预策略可显著降低呼吸内科ICU患者CLABSI的发生率,减少患者不良预后,值得临床推广应用。

Objective:To evaluate the application effect of target management theory-based intervention strategy in preventing Central Line Associated Blood Stream Infection(CLABSI)among RICU patients.Methods:Patients with central vascular access devices from the RICU in a tertiary Grade A hospital during Jan 1,2019 to Dec 31,2020 were included in this study.The control group with routine nursing care were those during Jan 1,2019 to Dec 31,2019,and the intervention group with the target management theory-based intervention strategy on the basis of routine nursing care were during Jan 1,2020 to Dec 31,2020.The incidence of CLABSI,and the infection rate of PICC and CVC were compared between the two groups.Results:A total of 256 individuals were enrolled.For all the participants,9 individuals were suffered from CLABSI,the incidence rate of CLABSI was 4.889‰,and the case infection rate was 4.02%.The incidence rate of CLABSI in the control group was 8.917‰,and 1.894‰in the intervention group(P=0.043).Both the incidences of CLABSI in PICC catheterization and in CVC catheterization between the two groups were different respectively(P=0.028).Conclusion:The target management theory-based intervention strategy is benefit to decrease the incidence of CLABSI of patients in RICU obviously,to reduce the adverse prognosis,and it is worth to popularize in clinical nursing.