摘要
目的通过实施管理手段,预防和减少重症医学科危重患者中心静脉导管相关性血流感染的发生。方法采用循证思维查阅相关文献,根据科室实际情况建立预防中心静脉导管相关血流感染的集束化管理策略,包括置管过程监控、置管维护操作记录、保持管道密闭、不常规冲管、减少导管附属装置更换时间、治疗室集中配药、严格手卫生及无菌技术操作等,就实施前后导管相关性血流感染的发生例次及发生率进行前后对比。结果实施集束化管理策略2年来,绵阳市中心医院重症医学科在收治患者人次、住院总天数、中心静脉置管天数、中心静脉插管使用率、患者平均病情严重程度均增加的情况下,导管相关性血流感染发生例次及发生率均较2014年明显减少,至2016年无1例导管相关性血流感染发生。结论集束化管理策略有利于降低重症医学科危重患者导管相关性血流感染的发生,其中保持管道的密闭性和集中配药是最具影响性的两大因素。
Objective To prevent and reduce the incidence rate of central venous catheter-related blood flow infection in critically ill patients in ICU by means of management. Methods According to the actual situation of the department, the cluster management strategy for the prevention of central venous catheter related blood flow infection was established, including the monitoring of the catheterization process, the maintenance of the tube, the maintenance of the tube, the sealing of the pipe, the unconventional flush of the tube, and the reduction of the replacement time of the accessory device of the catheter. In the treatment room, centralized dispensing, strict hand hygiene and aseptic technique, etc., the occurrence and incidence of catheter-related blood flow infection were compared before and after the implementation. Results： cluster op- eration was ean＇ied out. Results In the past 2 years, the number of patients treated, the total days of hospitalization, the days of central venous catheterization, the utilization rate of central venous intubation, the average severity of the patients were increased. The incidence of catheter-related blood flow infection was significantly lower than that in 2014. By 2016, there was no case of catheter-related blood flow infection. Conclusion The cluster management strategy is helpful to reduce the incidence of catheter-related blood flow infection in critically ill patients. Among them, keeping the sealing of pipeline and centralized dispensing are the two most influential factors.
作者
汪迪
陈斌
WANG Di;CHEN Bin(Department of Medicine,Anzhou District Hospital of TCM,Mianyang,Siehuan Province,621000 China)
出处
《中国卫生产业》
2018年第17期28-29,32,共3页
China Health Industry
关键词
导管相关血流感染
中心静脉置管
集束化管理
护理管理
Catheter-associated blood flow infection
Central venous catheterization
Management
Nursing
