集束化护理在预防中心静脉导管相关性血流感染中的循证实践

目的 探讨集束化护理在预防中心静脉导管相关性血流感染中的应用并评价其效果。方法 纳入重症医学科在岗护士76名。选取2019年3-6月入住重症医学科留置中心静脉导管(central venous catfeter,CVC)的87例患者为对照组,2019年11月-2020年2月入住重症医学科留置CVC的83例患者为观察组,对照组采用常规护理,观察组采用基于循证实践的集束化护理,比较证据应用前后,ICU护士对CRBSI预防及管理的认知水平及2组中心静脉置管患者CRBSI的发生率。结果 最佳证据应用后,ICU护士对CRBSI预防及管理的相关知识得分高于应用前(t=16.367,P＜0.001),观察组导管相关性血流感染的发生率为明显低于对照组(χ²=4.088,P=0.043)。 结论 基于最佳证据的集束化护理措施的应用,可提升护理人员对证据相关知识的掌握程度,提高规范执行率,降低中心静脉导管相关性血流感染发生率,提高护理质量。

Evidence-based practice of cluster nursing in the prevention of central venous catheter-related bloodstream infection

Objective To explore the application of cluster nursing in the prevention of central venous catheter-related bloodstream infection (CRBSI) and evaluate its effect. Methods Seventy six nurses were enrolled in intensive care unit(ICU).A total of 87 patients with central venous catfeter (CVC) indurated in ICU from March to June 2019 were selected as the control group, and 83 patients with CVC indurated in ICU from November 2019 to February 2020 were selected as the observation group. The control group received routine care.The observation group was treated with cluster nursing based on evidence-based practice. The cognitive level of ICU nurses on the prevention and management of CRBSI and the incidence of CRBSI in the two groups were compared before and after the application of evidence. Results After the application of best evidence, ICU nurses' knowledge score on prevention and management of CRBSI was higher than before (t=16.367, P<0.001), and the incidence of catheter-related bloodstream infection in the observation group was significantly lower than that of the control group (χ²=4.088, P=0.043). Conclusion The application of cluster nursing based on the best evidence can improve nurses' knowledge about evidences, standardize their behavior, reduce the incidence of CRBSI and improve their nursing quality.