- 期刊
- OpenAccess
新生兒加護病房經皮式置入中心導管之阻塞與非計畫性拔除改善方案
A Project to Improve Occlusion and Unplanned Removal of Percutaneously Inserted Central Catheters (PICCs) in NICU
摘要
經皮式置入中心導管（percutaneously inserted central catheter, PICC）可長期留置於血管內，提供輸液、靜脈營養、給藥，並減少靜脈注射次數，廣泛應用於新生兒加護病房中。臨床工作中發現單位導管阻塞致非計劃性拔除有升高趨勢，經調查結果高達15.6 %，為改善此問題特成立專案小組，進行現況分析並提出改善方案。主要改善方案：（1）重新制定經皮式中心導管照護標準；（2）疑似導管阻塞處理流程；（3）進行在職教育；（4）成立品質監測稽核小組；（5）全面檢修輸液幫浦。經改善方案實施後導管阻塞之非計畫拔除率降至3.8%。本單位持續監測經皮式置入中心導管阻塞非計劃性拔除，2009年降至1.5%，2010年降至0.3%。顯示藉持續執行本專案介入措施確實有效防範導管阻塞導致之非計劃性拔除。
並列摘要
Peripherally inserted central venous catheters (PICCs) are widely used for in the NICU because they may be provided long-term access for fluid, total parenteral nutrition (TPN), medications, and reducing venipuncture. In clinical practice, observed there was a trend toward an increase for PICCs occlusion, we conducted a survey and found 15.6 % of unplanning removal of PICCs occlusion. We set up a project group to analysis problem and provide improvement program. Strategies to reduce unplanned removal of PICCs includes: (1) develop and practice based on the revised intravenous nursing standards of PICCs; (2) build up the management of suspected catheter occlusion; (3) Provide member continuing education; (4) set up nursing quality auditing team; (5) check all the infusion pumps for manufacturers. After the interventions implemented, the unplanned removal rate of PICCs had reduced from 15.6 to 3.8%. Continued to monitoring PICC lines occlusion unplanned removed rate showed that 2009 reduce to 1.5% and 2010 reducing to 0.3%. Continued this implementation of improvement project may effective for prevention unplanned removal rate of catheters occlusion.