摘要
目的汇总腔内心电图定位技术在PICC置管中的最佳证据,并调查最佳证据在临床的应用情况。方法计算机检索Cochrane Library、美国静脉输液护理学会、PubMed、ScienceDirect、中国知网、万方数据库、维普中文科技期刊网关于患者腔内心电图定位技术在PICC导管头端定位中的相关文献,检索时限为建库至2022年6月30日。采用澳大利亚乔安娜布里格斯研究所循证卫生保健中心的文献评价标准和证据分级系统进行文献质量评价及证据评级,汇总最佳证据。根据汇总证据形成腔内心电图定位引导PICC置管的最佳证据应用调查问卷。于2022年11—12月,采用滚雪球抽样方法,选取119名PICC护士进行问卷调查。结果共纳入31篇文献,其中随机对照试验24篇,系统评价2篇,Meta分析4篇,团体标准1篇。从操作前评估和准备、送管过程、导丝连接、引导腔内心电图、退管时机、最佳位置判断和效果评价7个方面汇总20条证据。调查结果显示,半数以上护士在评估和准备、送管过程、引导腔内心电图、导丝连接、退管时机方面与证据相一致,但最佳位置判断方法选择较为分散,有待进一步研究。结论本研究为腔内心电图定位PICC置管提供了循证依据,专科护士结合临床实际,有针对性地选择最佳证据,制订符合个体情况的置管方案,可以保障患者获益最大化,不断提升护理质量。
ObjectiveTo summarize the best evidence of intracavitary electroencephalogram positioning in peripherally inserted central catheter(PICC)catheterization,and investigate the clinical application of the best evidence.MethodsThe literature on the intracavitary electroencephalogram positioning technology in the head end positioning of PICC catheterization was searched through computers on websites or data bases such as Cochrane Library,Infusion Nursing Society,PubMed,ScienceDirect,China National Knowledge Infrastructure,WanFang Data,and VIP.The search period was from the establishment of the database to June 30,2022.The literature evaluation standards and evidence grading system of the Joanna Briggs Institute Evidence-Based Health Care Center Database were used for literature quality evaluation and evidence grading,summarizing the best evidence.Based on the summary of evidence,the best evidence for intracavitary electrocardiogram positioning guided PICC catheterization was applied to the survey questionnaire.From November to December 2022,a snowball sampling method was used to select 119 PICC nurses for a questionnaire survey.ResultsA total of 31 articles were included,consisting of 24 randomized controlled trials,two systematic reviews,four Meta-analysis,and one group standard.We summarized 20 pieces of evidence from 7 aspects,including preoperative evaluation and preparation,catheter delivery process,guidewire connection,guided intracavitary electroencephalogram,timing of catheter withdrawal,optimal position judgment,and effect evaluation.The survey results showed that more than half of the nurses were consistent with the evidence in terms of evaluation and preparation,catheter delivery process,guided intracavitary electroencephalogram,guidewire connection,and timing of catheter withdrawal.The selection of the optimal location judgment was relatively scattered and needed further research.ConclusionsThis study provides evidence-based basis for the PICC catheterization positioning using intracavitary electroencephalogram.Based on clinical practice,specialized nurses select the best evidence and develop a management plan that suits individual circumstances,which can ensure maximum patient benefits and continuously improve nursing quality.
作者
富静
陈敏华
梁妙丽
张聪美
尚旭丽
Fu Jing;Chen Minhua;Liang Miaoli;Zhang Congmei;Shang Xuli(Vein Treatment Clinic,Lishui People's Hospital,Lishui 323000,China;Nursing Department,Lishui People's Hospital,Lishui 323000,China;Outpatient Department,Lishui People's Hospital,Lishui 323000,China)
出处
《中华现代护理杂志》
2023年第27期3681-3688,共8页
Chinese Journal of Modern Nursing
关键词
经外周置入中心静脉导管
心电引导
腔内心电图
证据总结
Peripherally inserted central venous catheter
Electrocardiogram guidance
Intracavitary electrocardiogram
Evidence summary
