质控小组管理在预防急性肾衰竭患者血液净化导管相关性血流感染中的应用

Application of quality control team management system in preventing blood purification catheter-related bloodstream infection in patients with acute renal failure

目的探讨质控小组管理在预防急性肾衰竭(ARF)患者血液净化导管相关性血流感染(CRBSI)中的应用,为制定预防干预措施提供参考。方法选择2020年4月至2022年4月在海口市人民医院行血液净化治疗的86例ARF患者作为研究对象,根据干预方式不同分对照组和观察组,每组43例。对照组接受常规干预;观察组接受质控小组管理。记录两组患者置管时间、住院时间、CRBSI发生时间、CRBSI持续时间、CRBSI发生率,比较两组患者CRBSI认知能力评分、遵医嘱依从性及对血液净化管理的满意度。结果观察组患者置管时间、住院时间、CRBSI持续时间均明显短于对照组〔置管时间(d):22.57±4.39比38.45±8.43,住院时间(d):30.28±5.37比45.37±8.14,CRBSI持续时间(d):7.04±2.11比13.27±3.45,均P<0.05〕,CRBSI发生时间晚于对照组(15.27±4.16比9.25±2.18,P<0.05);观察组患者CRBSI发生率明显低于对照组〔4.65%(2/43)比25.58%(11/43),P<0.05〕;且观察组患者CRBSI概念知识、感染途径、症状表现、预防方法、日常保健等认知能力评分均明显高于对照组〔概念知识(分)18.25±1.54比11.45±1.43,感染途径(分)17.84±2.05比12.29±1.74,症状表现(分)17.53±2.44比11.47±2.52,预防方法(分)18.03±1.86比13.62±2.58,日常保健(分)18.35±1.67比12.87±1.49,均P<0.05〕;遵医嘱依从率和防控管理满意度也均明显高于对照组〔依从率:93.02%(40/43)比69.77%(30/43),满意度:97.67%(42/43)比79.07%(34/43),均P<0.05〕。结论质控小组管理可明显降低ARF患者血液净化CRBSI发生率,缩短置管、住院及CRBSI持续时间,增强了患者对血液净化CRBSI的认知能力,提高其对干预管理的依从性和满意度。

Objective To study the application of quality control team management system in the prevention of blood purification catheter-related bloodstream infection(CRBSI)in patients with acute renal failure(ARF),and to provide reference for the formulation of CRBSI preventive interventions.Methods Eighty-six patients with ARF undergoing blood purification treatment in Haikou People's Hospital from April 2020 to April 2022 were selected as the research subjects.They were divided into a control group and an observation group according to the difference in intervention methods,with 43 cases in each group.The patients in the control group received conventional intervention method,and the patients in the observation group accepted the quality control team management system.The patients'times of intubation,hospital stay,occurrence and duration of CRBSI,and the incidence of CRBSI were recorded.The patients'scores of CRBSI cognitive ability,compliance of following doctor's advice and degree of satisfaction toward the blood purification management system were compared between the two groups.Results The intubation time,hospitalization time and duration of CRBSI in the observation group were significantly shorter than those in the control group[intubation time(days):22.57±4.39 vs.38.45±8.43,hospitalization time(days):30.28±5.37 vs.45.37±8.14,CRBSI duration(days):7.04±2.11 vs.13.27±3.45,all P<0.05],but the occurrence time of CRBSI in the observation group was later than that in the control group(15.27±4.16 vs.9.25±2.18,P<0.05);the incidence of CRBSI in the observation group was lower than that of the control group[4.65%(2/43)vs.25.58%(11/43),P<0.05];and the concept knowledge of CRBSI,infection routes,symptom manifestation,preventive methods,and daily health care in the patients of observation group were higher than those in the control group[concept knowledge(score):18.25±1.54 vs.11.45±1.43,infection route(score):17.84±2.05 vs.12.29±1.74,symptom manifestation(score):17.53±2.44 vs.11.47±2.52,prevention method(score):18.03±1.86 vs.13.62±2.58,daily health care(score):18.35±1.67 vs.12.87±1.49,all P<0.05];the patients'compliance rate of following doctor's advices and their satisfaction rate with the CRBSI prevention and control management system in the observation group were obviously higher than those of thee control groups[compliance rate:93.02%(40/43)vs.69.77%(30/43),satisfaction rate:97.67%(42/43)vs.79.07%(34/43),all P<0.05].Conclusions Quality control team management can significantly reduce the incidence of blood purification CRBSI in patients with ARF,shorten the times of intubation,hospital stay and duration of CRBSI,enhance their cognitive ability of blood purification CRBSI,and improve their rates of compliance and satisfaction with the intervention management.