作　　者： ; ; ;

机构地区： 中山大学附属第一医院

出　　处： 《现代临床护理》 2020年第2期14-19,共6页

摘　　要： 目的通过设计中心静脉导管维护"每日核查表"以加强护理人员对中心静脉导管护理的操作规范,降低导管相关并发症的发生。方法选择2016年10月至2017年9月在广州两家三级甲等综合医院使用"每日核查表"进行护理的留置中心静脉导管的住院患者1500例为观察组;回顾性统计2015年10月至2016年9月在这两家医院住院未使用"每日核查表"进行护理的留置中心静脉导管的住院患者1500例为对照组。观察及比较两组患者中心静脉导管相关血流感染(central line associated blood stream infection,CLABSI)、非计划性拔管(unplanned extubation,UEX)发生情况及使用"每日核查表"前后护士导管维护规范操作执行情况。结果观察组CLABSI发生率和UEX发生率分别为0.47%、0.73%低于对照组的0.87%和1.06%,两组比较,差异有统计学意义(χ^2分别为6.83、8.62,P<0.05)。使用"每日核查表"后护士导管维护规范操作总的执行率为98.21%较"每日核查表"前83.04%高,差异有统计学意义(χ^2=17.90,P<0.01)。结论采用"每日核查表",有效地提高了中心静脉导管维护措施的落实,降低了中心静脉导管相关性血流感染和非计划性拔管的发生率,保证了患者安全。该方法简单、可操作性强,护士接受程度高,值得临床推广应用。 Objective Through the design of central venous catheter maintenance"Daily Checklist"to strengthen the nurses operation specification of central venous catheter,reduce the occurrence of catheter-related complications.Methods Toally 1500 inpatients who indwelling central venous catheter and using the"Daily Checklist"in two Grade 3 A general hospitals in Guangzhou from October 2016 to September 2017 were selected as the observation group,and 1500 inpatients who were not using the"Daily Checklist"from October 2015 to September 2016 were counted as the control group.To observe and compare the differences on incidence of central line associated bloodstream infection(CLABSI),unplanted extubation(UEX)in the two groups and the implementation of nurse operation standard of catheter maintenance before and after using of the"Daily Checklist".Results The CLABSI rate and UEX rate of the observation group were 0.47%,0.73%,which were lower than those of the control group,0.87%and 1.06%respectively.The difference was statistically significant(χ^2=6.83,8.62,P<0.05).The total implementation rate of standard catheter maintenance of nurses after using the"Daily Checklist"was 98.21%higher than that before 83.04%.The difference was statistically significant(χ^2=17.90,P<0.01).Conclusions Using the"Daily Checklist"can effectively improve the implementation of central venous catheter maintenance measures,reduce the incidence of CLABSI and UEX,and ensure the safety of patients.The method is simple,operable and highly accepted by nurses,which is worthy of clinical application.

关 键 词： 中心静脉导管 每日核查表 中心静脉导管相关血流感染 非计划性拔管 护理

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