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首页> 美国卫生研究院文献>BMJ Open Quality >Improving Peripherally Inserted Central Catheter (PICC) care on a Trauma and Orthopaedics ward
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Improving Peripherally Inserted Central Catheter (PICC) care on a Trauma and Orthopaedics ward

机译：改善创伤和骨科病房周围插入的中央导管（PICC）的护理

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摘要

Peripherally Inserted Central Catheter (PICC) blockage rate was audited over a two month period on the Trauma & Orthopaedics ward at our District General Hospital. A 70% (five out of seven) PICC blockage rate was observed. High blockage rates lead to potential treatment complications, delays in delivery of treatment, increase in costs, and reduction in patient satisfaction. The factors contributing to the significant blockage rate include, long and contradictory PICC care guidelines, no information sheets in the patient notes, lack of training and awareness about care of, and flushing of, PICC lines, and lack of accountability for PICC flushing. Our project aimed to achieve a greater rate of PICC patency. We produced one succinct and comprehensive PICC care guideline, carried out staff training sessions, introduced a sticker reminding staff to flush the PICC line after use, and introduced a prescription of weekly heparin saline and PRN saline flushes (for monitoring and accountability). We used questionnaires to assess competency of hospital staff pre-teaching (doctors 6%, nurses 0%), and post-teaching (doctors 70%, nurses 38%). Blockage rate data post-intervention is pending. Education improved awareness of guidelines amongst staff and we anticipate that the proposed interventions will translate into reduced blockage rates, improving patient outcomes and reducing costs.
机译：在我们地区综合医院的创伤与骨科病房进行了为期两个月的审核，检查了中心插入导管（PICC）的阻塞率。观察到PICC阻塞率为70％（七分之五）。高阻塞率会导致潜在的治疗并发症，延误治疗，增加成本并降低患者满意度。导致显着阻塞率的因素包括：长期而矛盾的PICC护理指南，患者笔记中没有信息单，缺乏培训和对PICC管线的护理和冲洗的认识以及对PICC冲洗的责任感不足。我们的项目旨在提高PICC的通畅率。我们制定了一个简洁而全面的PICC护理指南，进行了员工培训，介绍了一个提醒员工使用后冲洗PICC管线的标签，并介绍了每周一次肝素盐水和PRN盐水冲洗的处方（用于监测和问责制）。我们使用问卷调查来评估医务人员教学前（医生6％，护士0％）和教学后（医生70％，护士38％）的能力。干预后的阻塞率数据正在处理中。教育提高了工作人员对准则的认识，我们预计拟议的干预措施将转化为降低阻塞率，改善患者预后并降低成本。

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