中华现代护理杂志
中華現代護理雜誌
중화현대호리잡지
CHINESE JOURNAL OF MODERN NURSING
2012年
10期
1127-1130
,共4页
窦英茹%潘春芳%单雪芹%史甜%朱庆捷
竇英茹%潘春芳%單雪芹%史甜%硃慶捷
두영여%반춘방%단설근%사첨%주경첩
集束化预防策略%导管相关性血流感染%ICU%影响因素
集束化預防策略%導管相關性血流感染%ICU%影響因素
집속화예방책략%도관상관성혈류감염%ICU%영향인소
Bundle prevention strategies%Catheter-relatrd bloodstream infections%ICU%Influence factors
目的 探讨集束预防策略对导管相关性血流感染( CRBSI)发生率的影响.方法 选取入住ICU并行中心静脉置管的患者1 405例为研究对象,根据是否发生CRBSI,分为感染组117例和未感染组1 288例.对每例患者实施集束预防策略,每日进行评估.分析集束预防策略中的各项措施与CRBSI发生率的关系.结果 本研究患者总置管天数17 317 d,导管平均留置时间12.85 d,感染发生率为6.8/1000导管留置日.两组患者性别、年龄、肤贴种类、更换肤贴时间和是否输入TPN差异均无统计学意义(P＞0.05)；感染组患者APACHEII评分＞20分占78.63％、住ICU时间＞30 d占38.46％、紧急插管占17.95％、接受倾入性操作频次＞4次占83.76％、导管留置时间＞7d占78.63％均高于非感染组(51.86％,15.53％,7.84％,35.02％,31.13％),差异均具有统计学意义(x2值分别为8.071,23.750,10.781,36.56,44.886；P＜0.05)；感染组患者操作时提供最大无菌屏障的合格率占45.30％、操作中接头消毒的合格率占68.38％、锁骨下静脉置管占40.17％均低于非感染组(75.93％,94.33％,59.94％),差异均具有统计学意义(x2值分别为9.303,4.604,5.076;P＜0.05)；多元回归分析显示操作中接头消毒的合格率是影响CRBSI发生的独立因素(OR =4.992,P＜0.01).结论 实行集束化预防策略,加强导管接头消毒管理可以降低CRBSI的发生率.
目的 探討集束預防策略對導管相關性血流感染( CRBSI)髮生率的影響.方法 選取入住ICU併行中心靜脈置管的患者1 405例為研究對象,根據是否髮生CRBSI,分為感染組117例和未感染組1 288例.對每例患者實施集束預防策略,每日進行評估.分析集束預防策略中的各項措施與CRBSI髮生率的關繫.結果 本研究患者總置管天數17 317 d,導管平均留置時間12.85 d,感染髮生率為6.8/1000導管留置日.兩組患者性彆、年齡、膚貼種類、更換膚貼時間和是否輸入TPN差異均無統計學意義(P＞0.05)；感染組患者APACHEII評分＞20分佔78.63％、住ICU時間＞30 d佔38.46％、緊急插管佔17.95％、接受傾入性操作頻次＞4次佔83.76％、導管留置時間＞7d佔78.63％均高于非感染組(51.86％,15.53％,7.84％,35.02％,31.13％),差異均具有統計學意義(x2值分彆為8.071,23.750,10.781,36.56,44.886；P＜0.05)；感染組患者操作時提供最大無菌屏障的閤格率佔45.30％、操作中接頭消毒的閤格率佔68.38％、鎖骨下靜脈置管佔40.17％均低于非感染組(75.93％,94.33％,59.94％),差異均具有統計學意義(x2值分彆為9.303,4.604,5.076;P＜0.05)；多元迴歸分析顯示操作中接頭消毒的閤格率是影響CRBSI髮生的獨立因素(OR =4.992,P＜0.01).結論 實行集束化預防策略,加彊導管接頭消毒管理可以降低CRBSI的髮生率.
목적 탐토집속예방책략대도관상관성혈류감염( CRBSI)발생솔적영향.방법 선취입주ICU병행중심정맥치관적환자1 405례위연구대상,근거시부발생CRBSI,분위감염조117례화미감염조1 288례.대매례환자실시집속예방책략,매일진행평고.분석집속예방책략중적각항조시여CRBSI발생솔적관계.결과 본연구환자총치관천수17 317 d,도관평균류치시간12.85 d,감염발생솔위6.8/1000도관류치일.량조환자성별、년령、부첩충류、경환부첩시간화시부수입TPN차이균무통계학의의(P＞0.05)；감염조환자APACHEII평분＞20분점78.63％、주ICU시간＞30 d점38.46％、긴급삽관점17.95％、접수경입성조작빈차＞4차점83.76％、도관류치시간＞7d점78.63％균고우비감염조(51.86％,15.53％,7.84％,35.02％,31.13％),차이균구유통계학의의(x2치분별위8.071,23.750,10.781,36.56,44.886；P＜0.05)；감염조환자조작시제공최대무균병장적합격솔점45.30％、조작중접두소독적합격솔점68.38％、쇄골하정맥치관점40.17％균저우비감염조(75.93％,94.33％,59.94％),차이균구유통계학의의(x2치분별위9.303,4.604,5.076;P＜0.05)；다원회귀분석현시조작중접두소독적합격솔시영향CRBSI발생적독립인소(OR =4.992,P＜0.01).결론 실행집속화예방책략,가강도관접두소독관리가이강저CRBSI적발생솔.
Objective To explore the impact of bundle prevention strategies on the CRBSI incidence.Methods Patients admitted to ICU with central venous catheter were given daily assessment and target monitor from 2008.2 to 2010.2,and divided into infected (117 cases) and non-infected ( 1 288 cases) group according to whether there was CRBSI.Analysis the relationship between the measures of bundle prevention strategies and the incidence of CRBSI,all data applications SPSS 10.0 for windows statistical software package for statistical analysis.Results In the study,1405 cases were collected,and 117 cases were infected while 1288 cases were non-infected.The total number of catheter day was 17 317 days,and the average was 12.85 d.Infection rate was 6.8 per 1 000 catheter days.Sex,age,type of skin plaster and time of changing skin plaster and infusion TPN were not different between the two groups (P＞0.05).The single variable analysis has shown that the in the infection group,severity of clinical patients (APACHE Ⅱ ＞ 20 points) was 78.63％,ICU stay time( ＞ 30days) was 38.46％,emergency intubation method was 17.95％,patients received the frequency of invasive procedures( ＞4 times) was 83.76％,catheter day longer than 7 days was 78.63％ were higher than those in the non-infection group (51.86％,15.53％,7.84％,35.02％ and 31.13％,respectively) and the difference was significant ( x2 =8.071,23.750,10.781,36.56,44.886,respectively; P ＜ 0.05 ) ; the pass rate of maximum sterile barrier (45.30％),the timeliness of joint disinfection on normal operation (68.38％) and catheterization in subclavian vein (40.17％ ) in infection group were lower than non-infeclion group (75.93％,94.33％ and 59.94％,respectively) and the difference was significant (x2 =9.303,4.604,5.076,respectively;P ＜0.05).Multiple regression analysis showed that the joint disinfection timeliness on normal operation was the independence factor of affecting CRBSI incidence ( OR =4.992,P ＜ 0,01 ).Conclusions The implementation of bundle prevention strategies and strengthening the management of catheter connector can reduce the incidence of CRBSI.
