在重症监护病房护士中维护中央静脉导管的基于证据的实践:一个跨部门的多中心研究
Tianjun Zhou1, Chunlei Li1,2, Zhe Wang1,2
1School of Nursing, Fudan University, Shanghai, China.
Journal of clinical nursing
|March 24, 2025
概括
重症监护病房护士对中静脉导管维护捆绑的适度坚持. 改善坚持是减少中线相关血流感染 (CLABSI) 和提高患者的治疗结果的关键.
科学领域:
- 改善医疗保健质量 改善医疗保健质量
- 预防和控制感染的预防和控制.
- 护理实践 护理实践
背景情况:
- 中心线相关的血流感染 (CLABSI) 仍然是重症监护室 (ICU) 的一个重大问题.
- 尽管基于证据的包装增加以减少CLABSI,但在推实践和实际临床应用之间仍然存在差距.
- 这项研究解决了需要评估ICU中中央静脉导管 (CVC) 维护捆绑的坚持.
研究的目的:
- 调查基于证据的CVC维护在ICU护士之间的实践.
- 为了检查22所选定的医院的CVC维护包的遵守率.
- 确定CVC护理需要改进的领域,以减少CLABSI.
主要方法:
- 采用了一个多中心,横截面的研究设计.
- 从22家医院的重症监护室的注册护士收集数据,使用基于中央线捆绑的11个区域35项检查清单.
- 在积累了22000个中央线路日后,分析了坚持率,并根据STROBE检查清单进行报告.
主要成果:
- 在ICU护士中,CVC维护包的平均坚持率为87.40%.
- 对于"选择受管制的皮肤消毒剂"",管道密封"",管道冲洗"",敷料和导管固定"和"消毒皮肤和导管"的遵守率超过了90%.
- 在"导管和插入部位评估"",手部卫生"和"无菌导管接入枢纽"方面,观察到的遵守率最低,其中"在多学科患者护理轮期间的评估与签名确认"是最少遵循的项目. 患有CLABSI事件的医院的坚持率低于90%.
结论:
- 密切护理护士表现出对CVC维护包的适度遵守,强调需要进行干预以改善遵守.
- 建议在ICU进行进一步的研究,以通过有针对性的干预来评估和增强坚持.
- 开发和实施新的策略,包括持续教育和定期评估,对于尽量减少CLABSI和改善患者存活率至关重要.
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