Objective:To investigate the effectiveness and feasibility of using a central line bundle(CLB)guideline with a standard checklist in the prevention of peripherally inserted central catheter(PICC)-related infections(CR...Objective:To investigate the effectiveness and feasibility of using a central line bundle(CLB)guideline with a standard checklist in the prevention of peripherally inserted central catheter(PICC)-related infections(CRIs)in very low-birth-weight infants(VLBWIs).Methods:Fifty-seven VLBWIs who underwent PICC insertion at a hospital in Qingdao,China,between November 2012 and June 2013,were monitored with the CLB guideline and a standard checklist.Fifty-three VLBWIs who underwent PICC insertion were monitored by standard hospital procedures.The incidence of CRIs was compared between the two groups.Results:The incidence of infection significantly decreased from 10.0%catheter days in the control group to 2.2%catheter days in the study group(p<0.05).The indwelling catheter time significantly increased in the study group compared to the control group(31.9±15.0days vs.24.8±7.4 days,respectively,p<0.05).Colonization infections also decreased from 6.9% catheter days in the control group to 2.2%catheter days in the study group(p<0.05).The incidence of catheter-related bloodstream infections decreased from 3.1%catheter days in the control group to 0%catheter days in the study group.Conclusion:The use of a CLB guideline with a standard checklist could be an effective and feasible protocol for preventing CRIs and prolonging indwelling catheter timein VLBWIs.展开更多
目的探讨基于循证的临床质量改进在低出生体质量儿经外周静脉穿刺的中心静脉导管(peripherally inserted central venous catheter,PICC)相关并发症的应用效果。方法将厦门大学附属第一医院2021年6月至2022年6月新生儿科收治的92例低出...目的探讨基于循证的临床质量改进在低出生体质量儿经外周静脉穿刺的中心静脉导管(peripherally inserted central venous catheter,PICC)相关并发症的应用效果。方法将厦门大学附属第一医院2021年6月至2022年6月新生儿科收治的92例低出生体质量患儿分为研究组和对照组。对照组给予常规护理干预。研究组在常规护理基础上,基于循证的临床质量改进法干预。对比两组一次性穿刺成功、非计划拔管的情况及正常导管留置时间。记录两组并发症的发生情况。评估两组静脉炎的发生程度。结果研究组一次性穿刺成功率高于对照组(89.13%vs.69.57%,P=0.020),导管留置时间长于对照组[(25.38±5.19)d vs.(22.54±3.01)d,P=0.002],非计划拔管率低于对照组(4.35%vs.17.39%,P=0.044),并发症总发生率低于对照组(8.70%vs.19.57%,P=0.038),静脉炎严重程度低于对照组(P=0.030)。结论基于循证的临床质量改进有助于提高低出生体质量儿PICC的一次性穿刺成功率,延长导管留置时间,降低相关并发症的发生,减轻静脉炎的发生程度。展开更多
基金This project was funded by the National Natural Science Foundation of China(NSFC:81171774,81272056)。
文摘Objective:To investigate the effectiveness and feasibility of using a central line bundle(CLB)guideline with a standard checklist in the prevention of peripherally inserted central catheter(PICC)-related infections(CRIs)in very low-birth-weight infants(VLBWIs).Methods:Fifty-seven VLBWIs who underwent PICC insertion at a hospital in Qingdao,China,between November 2012 and June 2013,were monitored with the CLB guideline and a standard checklist.Fifty-three VLBWIs who underwent PICC insertion were monitored by standard hospital procedures.The incidence of CRIs was compared between the two groups.Results:The incidence of infection significantly decreased from 10.0%catheter days in the control group to 2.2%catheter days in the study group(p<0.05).The indwelling catheter time significantly increased in the study group compared to the control group(31.9±15.0days vs.24.8±7.4 days,respectively,p<0.05).Colonization infections also decreased from 6.9% catheter days in the control group to 2.2%catheter days in the study group(p<0.05).The incidence of catheter-related bloodstream infections decreased from 3.1%catheter days in the control group to 0%catheter days in the study group.Conclusion:The use of a CLB guideline with a standard checklist could be an effective and feasible protocol for preventing CRIs and prolonging indwelling catheter timein VLBWIs.
