PDCA护理在降低老年肿瘤病人PICC相关性感染和不良事件发生中的作用

    Effect of PDCA nursing on the related infection and incidence rate of adverse event in elderly tumor patients treated with PICC

    • 摘要: 目的:分析计划、执行、检查和处理(PDCA)护理模式在降低老年肿瘤病人外周静脉置入中心静脉导管(PICC)相关性感染和不良事件发生率中的作用。方法:将108例行PICC置管的老年肿瘤病人随机分为2组,各54例。对照组给予常规护理模式,干预组在对照组护理基础上给予PDCA护理模式。比较2组病人PICC相关性感染和不良事件发生等情况。结果:干预组 PICC相关性感染和非计划性拔管、机械性静脉炎、导管脱落及导管堵塞等不良事件总发生率(11.11%)较对照组(53.70%)明显降低(P<0.01)。干预组病人导管留置时间较对照组明显延长,其一次性穿刺成功率、置管依从性和满意度较对照组升高(P<0.05~P<0.01)。干预组病人对护理人员PICC操作技能、沟通能力、护理态度、责任心及对PICC意外事件处理能力等方面评分较对照组明显升高(P<0.01)。结论:PDCA护理模式可明显降低老年肿瘤病人PICC相关性感染和不良事件发生率,可明显提高护理质量,增加导管留置时间,亦能促进病人满意度的提高,因此具有良好的临床应用价值。

       

      Abstract: Objective:To analyze the effects of plan,do,check and action(PDCA) nursing mode on decreasing the related infection and incidence rate of adverse event in elderly tumor patients treated with peripherally inserted central catheter(PICC).Methods:One hundred and eight elderly tumor patients treated with PICC were randomly divided into the control group and intervention group(54 cases each group).The control group and intervention group were nursed using routine nursing mode and PDCA nursing mode on the basis of the control group,respectively.The PICC-related infection and adverse events between two groups were compared.Results:The total incidence rate of the PICC-related infection and adverse events such as unplanned extubation,mechanical phlebitis,catheter ablation and catheter blockage in intervention group(11.11%) were significantly lower than that in control group (53.70%)(P<0.01).Compared with the control group,the time of catheter indwelling significantly prolonged,the one-time puncture success rate,catheter compliance and satisfaction increased in intervention group(P<0.05 to P<0.01).The scores of PICC operation skill,communication skill,nursing attitude,responsibility and handling ability to PICC accident in intervention group were significantly higher than those in control group(P<0.01).Conclusions:PDCA nursing mode can significantly reduce the incidence rate of PICC-related infection and adverse events,improve the quality of nursing,increase the catheter retention time,and improve the satisfaction in elderly cancer patients,which has good clinical application value.

       

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