培训PICC置管技能中的影响因素及常见问题

目的：探讨护士初次学习PICC置管技能过程的影响因素与常见问题，为护士PICC置管技能培训提供参考。方法2011年8月～2013年8月，对15名护士进行 PICC置管技能培训，按自制的《PICC穿刺操作评价表》对护士操作的每一例置管过程进行评价，分析影响护士掌握置管技能的因素。结果15位护士共操作置管225例，每位护士穿刺操作平均分数与学习环境月平均置管例数呈正相关（P＜0．05），与操作平均间隔时间呈负相关（P＜0．05）。常见问题有术前未指导患者配合动作、穿刺成功退出穿刺针芯时按压血管手法不正确、导管尖端异位和一次穿刺失败。结论护士在学习PICC置管技能期间，所在科室的月平均置管例数、护士置管操作间隔天数会影响其学习PICC置管技能。

The influencing factors and frequently problems for nurse inserted PICC technique training program

Objective To study the influencing factors and frequently problems for nurse inserted PICC technique initial training and to provide experiences for future PICC training program .Method 15 nurses received PICC train-ing program from August 2011 to August 2013 was included in this study .All cases were monitored respectively . The influencing factors for learning the skill of catheterization was analyzed .Result 225 catheterizations were fin-ished by the 15 nurses .Average score of catheterization by each nurse was positive related with monthly inserted numbers （P〈0 .05） .While the score was negative related with equal time interval procedure ,there was significant-ly different （P〈0 .05） .The frequently problems included patients were not told the cooperate training before punc-ture ,uncorrected press method after punctured successful ,the dislocated of the catheter tip ,the failure rate of once puncture .Conclusion The average number of monthly catheterizations and the equal time interval procedure can influ-ence the learning of PICC catheterization for learners .