改善週邊置入中心靜脈導管血流感染成效

Promoting the effectiveness of peripheral inserted central venous catheter bloodstream infection

井慶芸(Ching-Yun Ching) ； 董弘一(Hong-Yi Tung) ； 詹慧珠(Hui-Chu Chan) ； 李曉青(Hsiao-Ching Lee) ； 吳淑芬(Shu-Fen Wu)

《安泰醫護雜誌》 22卷2期 (2016/12) Pp. 28-41

摘要

目的：週邊置入中心靜脈導管血流感染是醫療照護品質指標之一，本單位2011年血流感染密度為千分之11.6，故專案旨在降低血流感染密度至千分之5.0以下；提升導管置入及管路照護完整性達90%以上。方法：修制定週邊置入中心靜脈導管置放術及相關給藥、沖洗與鎖帽照護流程及監測表，規劃製作導管照護流程圖、護理指導手冊及多媒體教材；舉辦在職教育訓練等措施。結果：血流感染密度由千分之11.6降至千分之4.4，導管置入完整性由84.2%提升至100%，管路照護完整性由84.4%提升至98.7%，病患或主要照顧者週邊置入中心靜脈照護認知平均得分88.6分，換藥技術正確性可達89.6%。結論：臨床上落實標準護理技術於工作中，可確保病人安全及提升照護品質。

關鍵字

週邊置入中心靜脈導管 ； 血流感染密度 ； 照護品質

並列摘要

Purpose: Peripherally Inserted Central Catheter (PICC) bloodstream infection is an important indicator of care quality. The PICC infection rate in our unit was 11.6 per mille in 2011.We designed a project to (1) reduce the peripheral inserted central venous catheter bloodstream infection rate below 5.0 per mille in our unit; (2) raise the integrity of pipeline care more than 90%. Methods: The intervention strategies included (1) establishing a standardization catheter protocol and care checklist, (2) establishing catheter management standards and, (3) providing in-service education. Results: After implementation of strategies (1) the catheter bloodstream infection rate fell to 4.4 per mille, (2) PICC pipeline placement process accuracy rose from 84.2% to 100%, (3) PICC pipeline care accuracy rose from 84.4% to 98.7% and, (4) patient or caregivers PICC care cognitive average score 88.6, dressing skills for the correctness of 89.6%. Conclusion: This project effectively reduced catheter bloodstream infection rate, and show the implementation of the standard of clinical can to ensure patient safety and quality of nursing care. We want to share this experience to help other units improve quality of cancer care.

並列關鍵字

Peripherally Inserted Central venous Catheter (PICC) ； Bloodstream infections rate ； quality of care