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A Quasi-Experimental Study on the Preventive Effect of Risk-Stratified Nursing Interventions for PICC-Related
Chun-Jie Sun1, Li Ma1, Su-Yun Wang1
1Department of Nursing, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People's Republic of China.
Objective:
To analyze risk factors for PICC-related thrombosis in cancer patients and assess the preventive efficacy of a risk-stratified nursing intervention based on these factors.
Methods:
This prospective observational cohort study evaluated the preventive effect of risk-stratified nursing on PICC-related thrombosis in cancer patients. Chemotherapy patients undergoing PICC placement in the oncology department of our hospital from January 2023 to December 2024 were enrolled. Participants were allocated into two cohorts based on the implementation timeline of the nursing protocol: Control group (n=117) received routine PICC care (January 2023-December 2023), while intervention group (n=119) received risk-stratified nursing interventions (January 2024-December 2024) guided by a logistic regression model identifying key thrombosis risk factors (eg, tumor staging, comorbid diabetes, D-dimer levels).
Results:
The intervention group (2024) exhibited a significantly lower PICC-related thrombosis incidence compared to the control group (2023) (4.20% vs 29.91%, χ²=28.436, P<0.001). Multivariate analysis identified tumor stage III/IV (OR=2.556, 95% CI 1.798-5.564), history of thrombosis (OR=19.273, 95% CI 10.674-37.561), diabetes (OR=2.572, 95% CI 1.027-5.712), catheter tip malposition (OR=14.339, 95% CI 8.916-29.795), and elevated D-Dimer (OR=9.528, 95% CI 6.703-15.597) as independent risk factors, while anticoagulant use (OR=0.449, 95% CI 0.089-0.874) was protective. In the intervention cohort, protocol-guided anticoagulation showed enhanced protection (OR=0.332, 95% CI 0.121-0.898, P=0.028). The intervention group also demonstrated improved quality of life across all SF-36 domains (eg, physical functioning: 58.94±1.97 vs 45.93±3.02, P<0.05) and significantly higher nursing satisfaction (96.64% vs 86.32%, χ²=8.091, P=0.004).
Conclusion:
Risk-stratified nursing interventions, guided by logistic regression analysis of thrombosis risk factors, significantly reduce PICC-related thrombosis incidence and improve patient quality of life and nursing satisfaction. This protocol offers a practical framework for oncology nursing to enhance patient outcomes.
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