以危机预防理论为指导的新生儿PICC置管风险管理方案的构建及应用

Construction and Application of Risk Management Plan for Neonates PICC Placement Guided by Crisis Prevention Theory

目的构建以危机预防理论为指导的新生儿经外周静脉穿刺的中心静脉导管(PICC)置管风险管理方案,并探讨其应用效果。方法前瞻性选取郑州大学第一附属医院新生儿重症医学科2021年3月至2022年2月收治的66例拟行PICC置管的新生儿为对象,按照收治时间顺序分为对照组和观察组,各33例。对照组患儿接受常规护理干预,观察组患儿在对照组基础上接受以危机预防理论为指导的风险管理干预措施。对比两组患儿PICC置管1个月内风险事件(导管堵塞、液体外渗、皮下血肿、感染)发生情况。对比穿刺时疼痛情况[新生儿急性疼痛行为评分量表(NIAPAS)及脸、腿、活动、哭闹、安抚评估量表(FLACC)]。结果观察组风险事件总发生率低于对照组(P<0.05)。观察组穿刺时NIAPAS、FLACC评分均低于对照组(P<0.05)。结论以危机预防理论为指导的风险管理干预措施可减轻新生儿PICC置管穿刺痛感,降低置管后风险事件发生率。

Objective To construct the risk management plan of peripherally inserted central catheter(PICC)in neonates guided by crisis prevention theory,and to explore its application effect.Methods A prospective cohort study was conducted to select 66 neonates who were admitted to the Department of Neonatal Intensive Care Medicine of the First Affiliated Hospital of Zhengzhou University from March 2021 to February 2022.They were divided into control group and observation group in chronological order of admission,with 33 cases in each group.The control group received routine nursing interventions,while the observation group received risk management interventions guided by crisis prevention theory on the basis of the control group.The incidence of risk events(catheter blockage,fluid extravasation,subcutaneous hematoma,infection)within 1 month of PICC catheterization was compared between the two groups.The pain during puncture[neonatal infact acute pain assessment scale(NIAPAS)and face,leg,activity,crying and comfort assessment scale(FLACC)]were compared.Results The total incidence of risk events in the observation group was lower than that in the control group(P<0.05).The NIAPAS and FLACC scores of the observation group during puncture were lower than those of the control group(P<0.05).Conclusion Risk management interventions guided by crisis prevention theory can alleviate the piercing sensation of PICC catheterization in neonates,reduce the incidence of risk events after catheterization,and have good application effects.