降低中心静脉导管患者非计划性拔管率的集束化护理策略构建及效果

Construction and Effectiveness of Cluster Nursing Strategy to Reduce Unplanned Extubation Rates of Central Venous Catheter Patients

目的 探讨降低中心静脉导管患者非计划性拔管率的集束化护理策略构建及效果。方法 选择2019年4月—2021年4月医院收治的留置中心静脉导管患者150例作为研究对象,采取随机数字抽取表法将其分为2组,每组75例。对照组采取常规护理干预;观察组在此基础上构建集束化护理策略。观察两组患者非计划性拔管率及其他并发症发生情况,评价两组患者的自我管理能力和心理状态。结果 观察组非计划性拔管率、血流感染率、渗血率、导管脱落率、静脉炎率显著低于对照组(P<0.05)。护理后,观察组自我护理能力、自我责任感、自我概念和健康知识等评分显著高于对照组(P<0.05)。护理后,观察组SAS、SDS评分显著低于对照组(P<0.05)。结论 针对留置中心静脉导管患者落实集束化护理策略可减少非计划性拔管,预防其他并发症,确保护理安全,并提高患者的自我管理能力,改善患者心理状态,护理价值较高。

Objective To explore construction and effect of cluster nursing strategy to reduce unplanned extubation rate of central venous catheter patients.Methods The paper chose 150 patients with indwelling central venous catheter admitted to the hospital from April 2019 to April 2021 as study subjects,and divided them into two groups with random number extraction table method,with 75 cases in each group.Control group was treated with routine nursing intervention,while observation group with cluster nursing strategy on the basis.Unplanned extubation rate and other complications between two groups were observed,and self-management ability and psychological state was evaluated.Results Unplanned extubation rate,bloodstream infection rate,bleeding rate,catheter detachment rate and phlebitis rate in observation group was 1.33%,0.00%,0.00%,and 1.33%respectively,significantly lower than control group(9.33%,5.33%,6.67%,10.67%,and 6.67%respectively)(P<0.05).After nursing,self-care ability,sense of responsibility,self-concept,and health knowledge scores of observation group were significantly higher than control group(P<0.05).After nursing,the SAS and SDS scores in observation group were significantly lower than control group(P<0.05).Conclusion Cluster nursing strategy can reduce unplanned extubation,prevent other complications,ensure optimal nursing safety,improve self-management ability,alleviate psychological state of patients with indwelling central venous catheter,which has high nursing value.