[1]祝薇,杨益群,刘明红,等.中心静脉通路装置相关性皮肤损伤预防方案在门诊经外周静脉置入中心静脉导管患者中的多中心应用研究[J].军事护理,2023,40(12):30-33,80.[doi:10.3969/j.issn.2097-1826.2023.12.008]
　ZHU Wei,YANG Yiqun,LIU Minghong,et al.Multicentered Application of a Prevention Programme on Central Venous Access Device-associated Skin Impairment Among PICC Outpatients[J].Nursing Journal Of Chinese People's Laberation Army,2023,40(12):30-33,80.[doi:10.3969/j.issn.2097-1826.2023.12.008]
点击复制

中心静脉通路装置相关性皮肤损伤预防方案在门诊经外周静脉置入中心静脉导管患者中的多中心应用研究
分享到：

《军事护理》[ISSN:2097-1826/CN:31-3186/R]

卷:
40
期数:
2023年12期
页码:
30-33,80
栏目:
论著
出版日期:
2023-12-15

文章信息/Info

Title:
Multicentered Application of a Prevention Programme on Central Venous Access Device-associated Skin Impairment Among PICC Outpatients
文章编号:
2097-1826(2023)12-0030-05
作者:
祝薇1; 杨益群2; 刘明红3; 卫雯诗1; 杨靖华4; 姚建琴5; 李莉6; 肖雪月7; 赵敏艳8; 瞿红9; 屈惠琴10
(1.苏州大学苏州医学院 护理学院,江苏 苏州 215006; 2.苏州大学附属独墅湖医院 护理部,江苏 苏州 215000; 3.苏州大学附属第一医院 血液科,江苏 苏州 215006; 4.江阴市人民医院 护理部,江苏 无锡214400; 5.苏州市立医院东区 护理部,江苏 苏州 215001; 6.常熟市第二人民医院 门诊部,江苏 苏州 215501; 7.江南大学附属医院 静脉治疗护理门诊,江苏 无锡 214000; 8.苏州大学附属第二医院 肿瘤科,江苏 苏州 215004; 9.苏州市第九人民
Author(s):
ZHU Wei1; YANG Yiqun2; LIU Minghong3; WEI Wenshi1; YANG Jinghua4; YAO Jianqin5; LI Li6; XIAO Xueyue7; ZHAO Minyan8; QU Hong9; QU Huiqin10
(1.School of Nursing,Suzhou Medical College,Soochow University,Suzhou 215006,Jiangsu Province,China; 2.Department of Nursing,Dushu Lake Hospital,Soochow University,Suzhou 215000,Jiangsu Province,China; 3.Department of Hematology,The First Affiliated Hospital of Soochow University,Suzhou 215006,Jiangsu Province,China; 4.Department of Nursing,Jiangyin People's Hospital,Wuxi 214400,Jiangsu Province,China; 5.Department of Nursing,Suzhou Municipal Hospital East Region,Suzhou 215001,Jiangsu...)
关键词:
中心静脉通路装置;  经外周静脉置入中心静脉导管;  皮肤损伤;  预防;  医用粘胶相关性皮肤损伤;  医疗器械相关压力性损伤
Keywords:
central venous access device;  peripherally inserted central catheter(PICC);  skin impairment;  prevention;  medical adhesive-related skin injury(MARSI);  medical device related pressure ulcers(MDRPU)
分类号:
R452
DOI:
10.3969/j.issn.2097-1826.2023.12.008
文献标志码:
A
摘要:
目的 探讨中心静脉通路装置(central venous access device,CAVD)相关性皮肤损伤(CAVD-associated skin impairment,CASI)预防方案在门诊经外周静脉置入中心静脉导管(peripherally inserted central catheter,PICC)患者中的应用效果。方法 便利抽样法选取苏州市、无锡市8所三级综合医院门诊行PICC维护的1043例患者为研究对象并采用整群随机对照试验。其中4所医院为对照组,给予PICC常规护理; 4所医院为试验组,在常规护理基础上予以CASI预防方案。干预6个月后,比较两组患者CASI发生率、医用粘胶相关性皮肤损伤(medical adhesive-related skin injury,MARSI)及医疗器械相关压力性损伤(medical device related pressure ulcers,MDRPU)发生率和严重程度、血管导管相关感染率和非计划拔管率的差异。结果 试验组CASI、MARSI及MDRPU发生率均低于对照组(均P<0.05),两组MARSI、MDRPU严重程度及非计划拔管率无统计学差异(均P>0.05)。两组均未发生血管导管相关感染。结论 实施CASI预防方案有利于降低PICC门诊患者CASI的发生率,为临床护士预防CASI提供实践指导。
Abstract:
Objective To explore the effect of application of a prevention programme on central venous access device-associated skin impairment among PICC Outpatients.Methods From September 2020 to March 2021,a total of 1043 patients who underwent PICC maintenance in the PICC clinics of eight tertiary hospitals in Suzhou and Wuxi were selected as the objects of a cluster randomized controlled trial.Four hospitals were used as the control group,and patients recruited in the control group were given PICC routine care; four hospitals as the intervention group,given CASI prevention programme based on routine care.After six months of intervention,the incidence of central venous access device-associated skin impairment(CASI),the incidence and severity of medical adhesive-related skin injury(MARSI),medical device-related pressure ulcers(MDRPU),PICC unplanned removal rate and catheter-related infections were compared between the two groups.Results The incidence of CASI,MARSI,and MDRPU in the intervention group and the control group were statistically significant(all P<0.05).There were no significant differences between the severity of MARSI,MDRPU,and unplanned removal rates of the two groups.No catheter-related infections happened in either group.Conclusions Implementing evidence-based CASI prevention programme significantly reduces the incidence of CASI in PICC outpatients and provides a reference for clinical nurses to prevent CASI.

参考文献/References:

[1] 黄培培,钦晓英,朱薇,等.PICC相关性血栓风险评估工具的范围综述[J].护理学杂志,2023,38(11):113-116.
[2] ULLMAN A J,KLEIDON T M,TURNER K,et al.Skin complications associated with pediatric central venous access devices:prevalence,incidence,and risk[J].J Pediatr Oncol Nurs,2019,36(5):343-351.
[3] ULLMAN A J,MIHALA G,O'LEARY K,et al.Skin complications associated with vascular access devices:a secondary analysis of 13 studies involving 10,859 devices[J].Int J Nurs Stud,2019(91):6-13.
[4] 杨艳英,曾丹,王海燕.肿瘤病人PICC置入部位医用粘胶剂相关性皮肤损伤的多因素分析[J].全科护理,2022,20(1):97-101.
[5] ZHAO H,HE Y,WEI Q,et al.Medical adhesive-related skin injury prevalence at the peripherally inserted central catheter insertion site:a cross-sectional,multiple-center study[J].J Wound Ostomy Continence Nurs,2018,45(1):22-25.
[6] 毛丽娜,文素芳,冯淑慧.皮肤力学理论在老年肿瘤患者PICC维护中的应用[J].护理学杂志,2020,35(17):49-51.
[7] 张晓雪,王硕,张宇,等.ICU老年患者医用粘胶相关性皮肤损伤现况及影响因素分析[J].护理学杂志,2022,37(6):54-57.
[8] 何满兰,何虹,杨鑫.住院病人医用粘胶相关性皮肤损伤危险因素的Meta分析[J].护理研究,2021,35(12):2069-2077.
[9] 赵思华.肿瘤患者中心静脉输液装置应用现状及相关并发症影响因素研究[D].兰州:兰州大学,2020.
[10]蔡佩源,孙国珍,李丽,等.中心静脉血管通路装置医用粘胶相关性皮肤损伤预防措施的最佳证据总结[J].中华现代护理杂志,2021,27(32):4351-4356.
[11]柳静,刘春芳,李秀川,等.PICC导管相关皮肤损伤预防的最佳证据总结[J].中华护理杂志,2022,57(16):1987-1994.
[12]徐寅,谢士芳,夏冬云,等.预防老年患者医用粘胶相关性皮肤损伤的皮肤管理策略[J].护理学杂志,2019,34(19):53-55.
[13]黄盼盼,陈劼,胡晓静,等.NICU患儿医用粘胶相关性皮肤损伤最佳循证实践方案的应用[J].护理学杂志,2021,36(22):45-48,79.
[14]卫雯诗.成人中心静脉通路装置相关性皮肤损伤护理方案的构建及验证[D].苏州:苏州大学,2021.
[15]何华,刘利,杨靖,等.改良移除和粘贴敷贴方法预防PICC患者医用粘胶相关性皮肤损伤的效果观察[J].护理学报,2019,26(7):61-64.
[16]MCNICHOL L,LUND C,ROSEN T,et al.Medical adhesives and patient safety:state of the science:consensus statements for the assessment,prevention,and treatment of adhesive related skin injuries[J].J Wound Ostomy Continence Nurs,2013,40(4):365-380.
[17]European Pressure Ulcer Advisory Panel,National Pressure Injury Advisory Panel and Pan Pacific Pressure Injury Alliance.Prevention and treatment of pressure ulcers/injuries:clinical practice guideline.The international guideline(2019)[EB/OL]. [2023-06-07].https://internationalguideline.com/.
[18]国家卫生健康委办公厅.血管导管相关感染预防与控制指南(2021版)[EB/OL].[2023-06-07].http://www.nhc.gov.cn/yzygj/s7659/202103/dad04cf7992e472d9de1fe6847797e49.shtml.
[19]许湘华,谌永毅,周莲清.医用胶粘剂相关性皮肤损伤的研究进展[J].解放军护理杂志,2017,34(3):51-54.
[20]陈一丹,端烨,唐迎迎,等.2021版输液治疗实践标准之导管相关皮肤损伤解读[J].军事护理,2022,39(8):89-92.
[21]陶娟,钟亮,车恒英.PICC带管患者皮肤压力性损伤的影响因素分析[J].中国医药导报,2021,18(30):176-179.

相似文献/References:

[1]张蕾,李英华,莫晓晨,等.肿瘤患者耐高压注射型经外周静脉置入中心静脉导管堵管风险因素的调查分析[J].军事护理,2021,38(01):75.[doi:10.3969/j.issn.1008-9993.2021.01.020]
　ZHANG Lei,LI Yinghua,MO Xiaochen,et al.Survey on the Risk Factors of High Pressure Resistant Peripherally Inserted Central Catheter Blockage among Tumor Patients[J].Nursing Journal Of Chinese People's Laberation Army,2021,38(12):75.[doi:10.3969/j.issn.1008-9993.2021.01.020]

备注/Memo

备注/Memo:
【收稿日期】2023-04-07【修回日期】2023-11-03
【基金项目】苏州市科技发展计划项目(SYSD-2019098); 苏州大学附属第一医院护理科研项目(HLYJ-2020-03)
【作者简介】祝薇,硕士在读,护士,电话:0512-65125097
【通信作者】杨益群,电话:0512-65955160
更新日期/Last Update: 2023-12-15