Risk management for peripherally inserted central catheter line care at home in 139 children
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摘要: 目的 寻求一种更安全、有效的管理模式,降低经外周静脉穿刺中心静脉置管(PICC)的管理风险,探讨风险管理在儿童PICC家庭留置中的应用效果,尤其是在导管堵塞,外渗,意外拔针/脱管,穿刺点感染几个方面,从而减低家庭留置的风险,提高患儿的生活质量。 方法 将昆明市儿童医院血液科2013年1—12月PICC导管家庭留置的139例患儿纳入研究。以2013年1—6月仅实施常规护理的72例患儿作为对照组,2013年7—12月在常规护理基础上应用风险管理的67例患儿作为观察组,针对对照组中出现的影响家庭留置效果的高危因素,实施相应的整改措施并运用到观察组中,比较2组中心静脉留置输液患儿出现导管堵塞、意外拔针/脱管、穿刺点感染等风险的发生情况及平均留置时间的差异性,运用SPSS统计软件对数据进行分析。 结果 风险管理实施前(对照组)异常情况发生率为22.22%,风险管理实施后(观察组)异常情况发生率降至5.97%,2组比较差异有统计学意义。同时,观察组的PICC导管留置时间[(214.58±16.90)d]较对照组[(181.63±12.38)d]明显延长,2组比较差异有统计学意义。 结论 风险管理是一种安全、有效的管理模式,其临床应用有利于提升患儿PICC家庭留置的安全性,减少并发症,延长留置时间,降低了需反复血管穿刺的风险及难度,减少了治疗费用,提高了患儿的生活质量和家属的满意度。
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关键词:
- 风险管理 /
- 血液科 /
- PICC导管家庭留置
Abstract: Objective To look for a more secure and efficient management model to decrease the manage risk of peripherally inserted central catheter(PICC),explore the application of risk management in the PICC care at home,and decrease the risk of indwelling PICC at home and improve the life quality of patients. Methods Total 139 patients with family PICC indwelling in Kunming Children’s Hospital from January to December in 2013 were enrolled into this study.72 cases with only routine care from January to June were assigned into the control group,while 67 children with routine care and risk management from July to December were assigned into the observation group.The risk factors affecting family PICC line indwelling in the control group were observed,and then the appropriate corrective measures were applied in the observation group.The incidence of catheter blockage,unplanned needle removal or extubation,and puncture site infections,and the mean time for PICC line indwelling were compared by using SPSS statistical software. Results The incidence of abnormal events before and after the implementation of risk management was 22.22%(control group) and 5.97%(observation group),respectively.There was a significant difference between these two groups.The PICC line indwelling periods was (181.63±12.38)days in the control group and (214.58±16.90)days in the observation group,the difference was statistically significant. Conclusion The risk management is a safe and effective management model,its clinical application will enhance the safety of children with family PICC line indwelling,reduce complications,extend the indwelling period,reduce the risk and difficulty of repeated vascular access,reduce the treatment costs,and improve the quality of life of children and family satisfaction.
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