Analysis of the Nursing Effect of Hierarchical Extended Nursing Based on The Guidance of Orem’s Theory in Patients with PICC Catheterization

Objective:To analyze the nursing effect of hierarchical extended nursing based on the guidance of Orem’s theory in patients with peripherally inserted central(PICC)catheterization.Methods:Ninety-one patients with PICC catheterization admitted to the hospital from May 2021 to May 2023 were selected and divided into a control group and an observation group,with 45 and 46 cases,respectively.The control group received routine nursing care,while the observation group received routine nursing care combined with hierarchical extended nursing based on the guidance of Orem’s theory for 3 months.Relevant indicators between the two groups were compared.Results:The improvement degree of various indicators in the observation group after nursing was better than that of the control group(P<0.05).Conclusion:Graded extended nursing based on the guidance of Orem’s theory improved the knowledge,belief,behavior,and self-efficacy of patients with PICC catheterization,and relieved their anxiety,depression,and other negative emotions.The nursing effect was deemed to be significant.

带量采购前后不同静脉留置针的临床使用情况及费用比较

目的通过对比带量采购前后不同静脉留置针的临床使用情况及整体费用,为优化临床决策、完善医用耗材带量采购提供参考。方法通过关键知情人访谈收集带量采购前后不同静脉留置针产品的临床使用情况,基于文献回顾及关键知情人访谈等构建模型对静脉留置针的整体费用进行分析。结果对来自南京和临沂的16家医院的27位临床护士进行了访谈。与带量采购前使用X品牌留置针相比,带量采购后使用中标品牌留置针的平均留置时间由3.7 d降为2.1 d,单个患者留置针平均用量由2.0个上升为3.5个。穿刺平均耗时增加,首次穿刺成功率降低,导管堵塞、脱管、发红、皮下血肿、液体渗漏、静脉炎等并发症发生率上升,留置针穿刺及耗材费用、并发症治疗、产品破损及护士人工费等上升。以100例使用静脉留置针的住院患者为1个研究单位,总费用从7765.4元上升到9338.7元,增加了1573.3元。结论带量采购后,静脉留置针的质量及临床使用出现一定的问题。尽管中标产品单价下降,但整体费用控制效果不如预期,甚至不降反增。建议逐步建立针对医疗耗材带量采购的质量和整体费用评价标准,加强对医用耗材带量采购事前、事中、事后的质量评估与临床使用监测,更全面地分析费用并进行决策。