肿瘤患者PICC部位医用粘胶相关性皮肤损伤风险分级预防方案的构建

Construction of a risk classification prevention plan for medical adhesive related skin injury at the PICC site of tumor patients

目的构建肿瘤患者经外周置入中心静脉导管(PICC)部位医用粘胶相关性皮肤损伤风险分级预防方案,为预防PICC皮肤损伤提供参考。方法本研究的整体研究时间为2022年4—7月。基于循证检索国内外文献,并结合前期调查结果,初步构建肿瘤患者PICC部位医用粘胶相关性皮肤损伤风险分级预防方案内容框架指标。采用目的抽样法,选取山西省14所三甲医院的20名静脉治疗专家,运用德尔菲法对专家进行2轮函询,确定肿瘤患者PICC部位医用粘胶相关性皮肤损伤风险分级预防方案。结果2轮专家函询问卷的有效回收率为100%,专家权威系数均为0.94,肯德尔和谐系数分别为0.12和0.16(P<0.001)。最终构建的肿瘤患者PICC部位医用粘胶相关性皮肤损伤风险分级预防方案包含6项一级指标和31项二级指标。结论本研究构建的肿瘤患者PICC部位医用粘胶相关性皮肤损伤风险分级预防方案具有科学性、针对性和实用性,可为PICC皮肤损伤的预防提供实践指导。

Objective To construct a risk classification prevention plan for medical adhesive related skin injury at the peripherally inserted central catheter(PICC)site of tumor patients,so as to provide reference for preventing PICC related skin damage.Methods The overall period of this study was from April to July 2022.Based on evidence-based search of domestic and foreign literature,and combined with preliminary investigation results,a preliminary framework index for the risk classification prevention of medical adhesive related skin injury at the PICC site of tumor patients was constructed.A total of 20 venous therapy experts from 14 ClassⅢhospitals in Shanxi Province were selected by purposive sampling.The Delphi method was used to conduct two rounds of consultation with experts to determine the risk classification prevention plan for medical adhesive related skin injury at the PICC site of tumor patients.Results The effective response rate of the two rounds of expert consultation questionnaires was 100%,with expert authority coefficients of 0.94 and Kendall's harmony coefficients of 0.12 and 0.16,respectively,with a statistically significant difference(P<0.001).The final constructed risk classification prevention plan for medical adhesive related skin injury at the PICC site of tumor patients included 6 first-level indicators and 31 second-level indicators.Conclusions The risk classification prevention plan for medical adhesive related skin injury at the PICC site of tumor patients in this study is scientific,targeted,and practical,and can provide practical guidance for the prevention of PICC-related skin injury.