CAJ | 학술논문

目的：探讨全程管理模式对肿瘤患者PICC置管并发症的影响。方法于2012年10月开始建立全程管理模式,对PICC置管患者运用PDCA循环模式的计划、执行、检查和处理4个阶段对环境、安全、质量、患者健康等管理方面进行要素整合,进行全院一体化的全程管理。比较分散管理(2012年1—10月)和实施后全程管理后(2012年11月—2013年12月)全院PICC置管数、一次置管成功率及并发症发生率,比较患者对护理服务的满意度。结果全院PICC置管数从275例上升至475例,一次置管成功率从94.9%上升到98.9%,差异有统计学意义(χ2=11.58,P<0.01)；全程管理组导管相关并发症发生率下降,机械性静脉炎发生率为1.8%,导管性相关感染发生率为2.1%,均低于分散管理组,差异有统计学意义(χ2值分别为5.99,25.17；P<0.01)。患者满意度从93.1%提高至97.1%,差异有统计学意义(χ2=6.53,P<0.05)。结论全程管理模式减少了肿瘤患者PICC置管并发症发生率,促进了患者安全,减轻了临床护理压力,提高了患者满意度,提升了专科护理质量。
목적：탐토전정관리모식대종류환자PICC치관병발증적영향。방법우2012년10월개시건립전정관리모식,대PICC치관환자운용PDCA순배모식적계화、집행、검사화처리4개계단대배경、안전、질량、환자건강등관리방면진행요소정합,진행전원일체화적전정관리。비교분산관리(2012년1—10월)화실시후전정관리후(2012년11월—2013년12월)전원PICC치관수、일차치관성공솔급병발증발생솔,비교환자대호리복무적만의도。결과전원PICC치관수종275례상승지475례,일차치관성공솔종94.9%상승도98.9%,차이유통계학의의(χ2=11.58,P<0.01)；전정관리조도관상관병발증발생솔하강,궤계성정맥염발생솔위1.8%,도관성상관감염발생솔위2.1%,균저우분산관리조,차이유통계학의의(χ2치분별위5.99,25.17；P<0.01)。환자만의도종93.1%제고지97.1%,차이유통계학의의(χ2=6.53,P<0.05)。결론전정관리모식감소료종류환자PICC치관병발증발생솔,촉진료환자안전,감경료림상호리압력,제고료환자만의도,제승료전과호리질량。
Objective To explore the effects of whole process management pattern on the complication of PICC among cancer patients. Methods From October 2012, we started to build up the whole process management pattern to plan, implement, check and cope with integration of 4 stages key element including environment, safety, quality and patient′s health for PICC patients, and it carried out in the whole hospital. We compared the number of PICC cases, success rate of first PICC insertion and incidence of complication between the time of January to October 2012 and the time of November 2012 to December 2013, and compared the patients′satisfaction of nursing quality. Results After the whole process management pattern used, the total number of PICC climbed from 275 cases to 475 cases and the success rate of first PICC insertion increased from 94. 9% to 98. 9% with statistical difference (χ2 =11. 58,P<0. 01). The incidences of complication declined, of which the rate of mechanical phlebitis was 1. 8%, infection related catheter 2. 1%, and all complications were lower than before the whole process management pattern used (χ2 =5. 99,25. 17, respectively; P <0. 01). The patients′satisfaction increased from 93. 1% to 97. 1% with statistical difference (χ2 =6. 53,P<0. 05). Conclusions The whole process management pattern declines the complications of PICC among cancer patients, and promotes patients safety, releases clinical pressure and enhanced patients′satisfaction and quality of specific nursing.