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在儿科中不适当使用外围插入的中央导管:一项多站点研究

Alina G Burek^1,2, Mary Beth Davis^3,4, Brittany Pechous³

¹Children's Wisconsin, Milwaukee, Wisconsin.

Hospital pediatrics

|February 26, 2024

概括

虽然大多数外围插入的中央导管 (PICC) 是合适的,但很大一部分不是. 这突出了通过优质倡议改善住院儿童的PICC使用的机会.

科学领域:

儿科医院医学儿科医院医学
血管接入装置是指血管接入装置.
改善医疗保健质量改善医疗保健质量

背景情况:

周边插入的中央导管 (PICC) 在儿科医院环境中被广泛使用.
标准化指导方针,如密歇根州适用性指南内静脉导管 (miniMAGIC) 在儿童中,旨在优化PICC利用.
机构之间PICC使用和适当性的变化需要评估.

研究的目的:

评估当前在住院儿童中PICC实践与儿童指南中的miniMAGIC的一致性.
为了识别不同临床场所PICC适当性的变化.
描述接受不符合适当性标准的PICC的儿童.

主要方法:

在4家美国儿童医院进行的回顾性研究 (2019年1月至2021年12月).
包括患有PICC的住院儿童 (不包括NICU患者).
使用miniMAGIC标准将PICC分类为适当,不适当或不确定的适当性.

主要成果:

在6051个PICC中,82%是适当的,9%是不适当的,9%是不确定的.
每年多达20%的PICC是不合适的,并且在不同地点之间存在差异.
不适当/不确定的PICC (n=1100) 常常是长期服用抗生素 (56%) 的,并与并发症 (6%) 相关,主要是脱落 (3%) 和闭塞 (2%).

结论:

大多数PICC符合适当性标准,但很大一部分没有.
在住院儿童中使用PICC的质量改善有显著的机会.
进一步的研究和有针对性的干预措施可以优化PICC的使用并减少相关的并发症.

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