摘要
目的研究与设计静脉留置针堵管风险预警及预控方案,并探索其在临床工作中的应用效果.方法本研究分为3个阶段:第一阶段通过文献回顾、专家咨询、层次分析法以及回顾性研究确立静脉留置针堵管风险预警方案;第二阶段通过文献检索与文献质量评价对静脉留置针堵管干预最佳证据进行汇总,通过专家咨询确立风险预控方案;第三阶段,便利选取吉林省某三级甲等医院部分科室的住院患者开展非同期对照实验,2018年5-6月使用静脉留置针的236例住院患者为观察组,2017年5-6月的218例住院患者为对照组,比较两组患者静脉留置针堵管发生率、静脉留置针留置时间.结果 形成了包含2个一级指标、8个二级指标、17个三级指标组成预警评估方案,确定了低风险、中风险、高风险3个预警级别,针对低、中、高不同预警级别形成预控方案;非同期对照试验结果显示,观察组患者静脉留置针堵管发生率低于对照组,两组比较差异有统计学意义(P<0.05);观察组患者静脉留置针留置时间长于对照组患者留置时间,两组比较差异有统计学意义(P<0.05).结论运用风险预警理论,形成风险因素综合评估方案,运用前瞻性护理思维实施针对性的预控方案,提高护士静脉留置针堵管风险识别与预控能力,降低留置针堵管发生率,有效延长留置时间.
Objective To study and design an early warning and pre-control scheme for the risk of intravenous catheter blockage and observe the application effect in the clinical practice.Methods This study was divided into three stages:the first stage established the risk early warning plan of intravenous indwelling catheter occlusion through literature review,expert consultation,analytic hierarchy process and retrospective research;the second stage summarized the best evidence of intravenous indwelling catheter occlusion intervention through literature retrieval and literature quality evaluation,and established the risk through expert consultation.In the third stage,by convenience sampling we selected the inpatients from some departments of a ClassⅢGrade A hospital in Jilin Province to carry out non-synchronous control experiment.A total of 236 inpatients who used intravenous indwelling catheter from May to June of 2018 were taken as the observation group,and 218 inpatients from May to June of 2017 were taken as the control group.The occurrence of intravenous indwelling catheter occlusion and indwelling time of intravenous indwelling catheter were compared between the two groups.Results A pre-warning evaluation scheme consisting of two first-level indicators,eight second-level indicators and 17 third-level indicators was formed,and three early-warning levels,low-risk,medium-risk and high-risk,were determined.A pre-control scheme was formed for different early-warning levels.The non-synchronous control experiment showed that the incidence of intravenous indwelling catheter occlusion in the observation group was higher than that in the control group,the difference between the two groups was statistically significant(P<0.05);the indwelling time of intravenous indwelling catheter in the observation group was longer than that in the control group,and the difference between the two groups was statistically significant(P<0.05).Conclusions The use of risk early warning theory,the forming of a comprehensive risk factor assessment program,and the use of forward-looking nursing thinking in the implementation of targeted pre-control program,can help to improve nurses'ability to identify and control the risk of intravenous indwelling catheter occlusion,reduce the incidence of indwelling catheter occlusion,and effectively prolong the indwelling time.
作者
郭彩霞
姜珊
魏春艳
刘聪
Guo Caixia;Jiang Shan;Wei Chunyan;Liu Cong(Department of Nursing,China-Japan Union Hospital of Jilin University,Changchun 130033,China)
出处
《中华现代护理杂志》
2019年第29期3714-3720,共7页
Chinese Journal of Modern Nursing
关键词
静脉留置针
堵管
预警
预控
Intravenous indwelling catheter
Occlusion
Early warning
Pre-control
