PDCA循环护理对行经外周静脉穿刺中心静脉导管重症监护患者的护理效果

Effect of PDCA circulation nursing on the nursing of ICU patients with peripherally inserted central venous catheters

目的 探究PDCA循环护理对行经外周静脉穿刺中心静脉导管(PICC)重症监护患者护理效果的影响。方法 以2020年1月至2021年12月在南京医科大学附属无锡市人民医院ICU行PICC置管的90例患者为研究对象,以2020年1~12月实施常规护理管理为对照组(45例),以2021年1~12月实施PDCA循环护理为观察组(45例)。对比2组的护理效果。结果 观察组的PICC置管不良事件总发生率低于对照组,住院天数短于对照组,满意度评分高于对照组,非计划拔管率低于对照组,差异均有统计学意义(P均<0.05)。实施3个月、6个月和12个月后,观察组护理人员的PICC日常维护质量评分均高于同期对照组(P均<0.05);2组在实施6个月和12个月后的评分均高于实施3个月后(P均<0.05);观察组在实施12个月后的评分均高于实施6个月后(P<0.05)。实施12个月后,2组护理人员的理论和实操考核评分均较实施前升高,且观察组的考核评分均较对照组更高,差异均存在统计学意义(P均<0.05)。结论 对行PICC置管的ICU患者应用PDCA循环护理,能够提高护理人员的PICC置管水平,减少不良事件和非计划拔管的发生,缩短患者住院天数,提高其满意度。

Objective To explore the effect of PDCA circulation nursing on the nursing of intensive care unit(ICU)patients with peripherally inserted central venous catheters(PICCs).Methods Ninety patients with PICCs in the ICU of Wuxi People's Hospital Affiliated to Nanjing Medical University from January 2020 to December 2021 were enrolled.The 45 patients who received routine nursing management from January to December 2020 were set as the control group,and the 45 patients who received PDCA circulation nursing from January to December 2021 were set as the observation group.The nursing effect of the two groups was compared.Results The observation group had a lower incidence of PICC-related adverse events,shorter duration of hospitalization,higher satisfaction scores,and a lower unplanned extubation rate than the control group(all P<0.05).After 3,6,and 12 months of implementation,the PICC daily maintenance quality scores of nursing staff in the observation group were higher than those in the control group(all P<0.05).The scores after 6 and 12 months of implementation in the two groups were higher than those after 3 months of implementation(all P<0.05).The scores after 12 months of implementation in the observation group were higher than those after 6 months of implementation(P<0.05).After 12 months of implementation,the theoretical and practical assessment scores of nursing staff in the two groups increased when compared with those before implementation,and the assessment scores of the observation group were higher than those of the control group(all P<0.05).Conclusion The application of PDCA circulation nursing in the ICU patients with PICCs can improve the PICC catheterization of nursing staff,reduce the adverse events and unplanned extubation,shorten the hospitalization,and improve the patient satisfaction.