摘要
目的探讨集束化护理在预防成人重症监护室(ICU)经外周静脉置入中心静脉导管(PICC)相关血栓中的应用价值,为预防PICC相关血栓提供新思路有望降低PICC相关血栓的发生率,减少患者的并发症风险,提高护理质量和患者满意度。方法选取医院2022年6月—2023年6月ICU收治并行PICC的患者82例为对象,按照时间顺序将2022年6—12月实施常规护理的41例患者纳入对照组,2023年1—6月开始行集束化护理的41例患者纳入观察组。比较观察两组患者一次性置管成功率、PICC相关血栓发生率及相关并发症(导管感染、机械性静脉炎、导管异位等)发生率,同时观察不同置管时间患者D-二聚体(D-D)水平变化;采用纽卡斯尔护理满意度量表(NSNS)调查比较患者家属护理满意度水平。结果观察组患者一次性置管成功率高于对照组,PICC相关血栓发生率低于对照组,差异有统计学意义(P<0.05),两组PICC其他并发症发生率比较差异无统计学意义(P>0.05)。在置管7 d后,观察组患者D-D水平低于对照组,差异有统计学意义(P<0.05)。观察组患者家属的临床护理满意度高于对照组,差异有统计学意义(P<0.05)。结论集束化护理在成人ICU行PICC患者的应用,能够提高一次性置管成功率、减轻凝血状态,继而有效预防PICC相关血栓发生,具有患者家属认可度高的特点,同时提高了患者的满意度。
Objective To explore the application value of cluster nursing in preventing peripherally inserted central venous catheters(PICC)-related thrombosis in adult intensive care unit(ICU),to provide new ideas for the prevention of PICC-related thrombosis,and aim to reduce the incidence of PICC-related thrombosis,decrease complication risk for patients,and enhance nursing quality and patient satisfaction.Methods A total of 82 patients admitted to the ICU and undergoing PICC of the hospital from June 2022 to June 2023 were selected as subjects.Grouping was conducted in chronological order,with 41 patients receiving routine nursing care from June to December 2022 included in the control group,and 41 patients receiving cluster nursing from January to June 2023 included in the observation group.The diff erences in the success rate of one-time catheterization,the incidence of PICC-related thrombosis,and related complications(catheter infection,mechanical phlebitis,catheter malposition,etc.)between the two groups of patients were compared.In addition,changes in D-dimer(D-D)levels in patients with diff erent catheterization times were observed.The Newcastle Satisfaction Nursing Scale(NSNS)was used to compare the level of nursing satisfaction among patients'families.Results The success rate of one-time catheterization in the observation group was higher than that in the control group,the incidence of PICC-related thrombosis was lower than that in the control group,the diff erences were statistically signifi cant(P<0.05),and there was no statistically signifi cant diff erence in the incidence of other PICC complications between the two groups(P>0.05).After 7 d of catheterization,the D-D level of patients in the observation group was lower than that in the control group,the diff erence was statistically signifi cant(P<0.05).The clinical nursing satisfaction of patients'families in the observation group was higher than that in the control group,the diff erence was statistically significant(P<0.05).Conclusion The implementation of cluster nursing in adult ICU patients undergoing PICC can enhance the success rate of one-time catheterization,alleviate coagulation status,thereby effectively preventing the occurrence of PICC-related thrombosis.Patients'families had a higher recognition and improves patient satisfaction.
作者
王文慧
卫晓静
王欣静
李婷
景孟娟
袁俊红
WANG Wenhui;WEI Xiaojing;WANG Xinjing;LI Ting;JING Mengjuan;YUAN Junhong(Henan Provincial People's Hospital,Zhengzhou 450000,China)
出处
《护理实践与研究》
2024年第5期746-751,共6页
Nursing Practice and Research
基金
河南省卫生健康委员会科研项目(编号:LHGJ20210036)。
关键词
重症监护室
集束化护理
外周静脉置入中心静脉导管
血栓
D-二聚体
Intensive care unit
Cluster nursing
Peripheral venous placement of central venous catheter
Thrombosis
D-dimer
作者简介
通信作者:卫晓静,硕士在读,副主任护师,护士长,E-mail:63799261@qq.com。
