介绍护士执业人员领导的外围插入的中央静脉导管安置程序对中央静脉接入装置的使用的影响:日本的一项回顾性研究
Hirotaka Sakai1, Miyuki Hirosue1, Mitsunaga Iwata1
1Department of Emergency Medicine and General Internal Medicine, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.
The journal of vascular access
|June 21, 2023
概括
日本的一项由护士执业人员领导的外围插入中心导管 (PICC) 计划显著减少了中央插入中心导管 (CICC) 的使用. 这一举措改善了血管接入管理,而不影响PICC安置质量或并发症率.
科学领域:
- 血管接入管理系统
- 改善医疗保健质量 改善医疗保健质量
- 护理实践 护理实践
背景情况:
- 护士带领的外围插入中央导管 (PICC) 团队已经在西方医院建立,但在日本才刚刚诞生.
- 实施专门的PICC程序可以增强血管接入管理.
- 护士领导的PICC团队对医院一级结果的影响需要正式调查.
研究的目的:
- 评估由执业护士 (NP) 领导的PICC计划对中央插入中心导管 (CICC) 使用的影响.
- 为了比较医生与NP进行的PICC插入的质量.
- 评估NP领导的PICC计划对日本血管接入装置使用和患者安全的影响.
主要方法:
- 在日本一所大学医院 (2014-2020年) 中央静脉接入装置 (CVAD) 安置的回顾性分析.
- 对每月CVAD使用趋势的中断时间序列分析.
- 对与PICC相关的并发症进行后勤回归和倾向得分分析.
主要成果:
- 在NP领导的PICC计划下,每月CICC使用率立即降低了35.5%,并且干预后的趋势是每月2.3.
- NP团队的PICC安置量大幅增加,而CICC使用量则下降.
- 与医生安置的PICC相比,NP安置的PICC (1.5%) 的直接并发症率较低 (5.1%).
- 在NP和医生组之间,中枢线相关的血流感染率与NP和医生组相似.
结论:
- 一个NP领导的PICC计划有效地减少了日本医院的CICC利用率.
- 该计划保持了PICC安置的质量,并且没有增加并发症率.
- 该模型展示了通过专门的护理团队优化血管访问管理的成功策略.
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