论文部分内容阅读
目的 了解中心静脉导管(CVC)置管临床实践(CLIP)依从性。方法 采用前瞻性研究设计,对2017年3月1日-2017年3月31日期间的江苏省12个省辖市开展调查,选择依从性较好的三级和二级医院。观察均在成人ICU中开展,通过统一培训的观察员观察CLIP依从性结果,通过手机软件调查,调查结果自动上传终端数据库。结果 共有24家医院参与本次调查,共观察CVC置管572次;其中三级综合医院487次占85.14%和二级医院85次占14.86%;置管前手卫生和皮肤消毒依从性较高,分别为94.41%和100.00%,最大无菌屏障依从性最低为77.27%,其中无菌隔离衣的依从性最低为87.9%;穿刺前消毒剂干燥和最大无菌屏障依从性医生分别为90.16%、75.79%,低于护士的98.44%、89.06%(P=0.028、P=0.017)。结论 ICU中CVC置管CLIP依从性不高,尤其是医生,需要加强培训、督查和反馈,从而预防导管相关血流感染,保障患者安全。
Objective To understand the clinical compliance (CLIP) of central venous catheter (CVC) catheterization. Methods A prospective study was conducted to investigate 12 prefectural cities in Jiangsu Province from March 1, 2017 to March 31, 2017, and to select tertiary and secondary hospitals with good compliance. Observations were carried out in adult ICU. CLIP compliance results were observed by uniform training observers. Surveys of the results were automatically uploaded to the terminal database. Results A total of 24 hospitals were involved in the survey. A total of 572 CVC catheterizations were observed. Among them, 487 were Grade III general hospitals, 85.14% were Grade II hospitals, and 14.86% were Grade II hospitals, with higher compliance with hand hygiene and skin disinfection before catheterization , Respectively 94.41% and 100.00%, the minimum sterile barrier compliance was the lowest 77.27%, of which the lowest isolates of sterile isolation clothing was 87.9%; pre-puncture disinfectant drying and maximum sterile barrier compliance doctors were 90.16% , 75.79%, lower than 98.44% and 89.06% of nurses (P = 0.028, P = 0.017). CONCLUSIONS: The compliance of CLIP in CVS in ICU is not high, especially for doctors. Training, supervision and feedback need to be strengthened so as to prevent catheter-related bloodstream infection and ensure patient safety.