品管圈在预防PICC导管相关性感染中的应用

目的成立外周中心静脉导管（peripherally inserted centralcatheter，PICC）品管圈，探讨引起PICC导管相关性感染的相关因素并制定护理措施，提高其操作的安全性，降低PICC导管相关性感染的发生率。方法2012年1月--2013年6月成立PICC品管圈，负责患者的P1CC穿刺置管、会诊、护理指导和培训，对导管的维护进行全程质量控制。结果PICC品管圈成立后，负责PICC导管维护的护理人员理论和操作水平较品管圈成立前差异有统计学意义（P〈0．01）；品管圈成立后导管相关性感染的发生率为3．95％（13／329），品管圈成立前的感染发生率为9．32％（22／236），两者差异有统计学意义（x2=6．82，P〈0．01）。结论合理选择留置导管的部位及PICC型号，严格遵守无菌操作技术，加强置管操作和标准维护的管理，严密观察携带PICC患者的每一个感染征兆，加强患者营养及提高抵抗力，是预防和降低PICC导管相关性感染的关键。

Role of quality control circle in preventing peripherally inserted central catheter catheter-related infections

Abstract：Objective Set up quality control circle（Qcc） of peripherally inserted central catheter（PICC） , to investigate the factors causing PICC catheter related infection and fornmlate measures for nursing, and to improve the safety of PICC technology and reduce the rates of catheter-related infections in hospital. Methods A QCC of PICC was established from Jan. 2012 to Jun. 2013. The group was responsible for PICC catheterising,medical consultation,PICC related guidance and training and maintenance of the whole process quality control of catheter for all the patients. Results After the establish- ment of QCC,it was responsible for the PICC catheter maintenance of nursing theory and operation level,which had have significant difference comparing with that without Qcc （P 〈 o. Ol ）. The catheter-related infection rate was 3.95% （ 13/ 329 ）, after the establishment of QCC, which was significantly lower than that 9.32% （22/236） before the establishment of the QCC （ X2 = 6.82, P 〈 0.01 ）. Conclusion The key points in preventing and reducing catheter-related infection rate were recommended proper selection of location for catheter intubation and appropriate size PICC, strict adherence to aseptic technique, strengthening the management of intubation and standardized maintaining procedures, paying close at- tention to the detection of infection signs and improving the patients＇ nutrition status and immunity.