CAJ | 학술논문

目的：以《导管相关血流感染预防与控制技术指南》的内容为依据，调查深圳市属6所综合医院成人ICU护士预防中心静脉导管相关血流感染知识和行为的现状，发现区域内综合医院ICU护士在预防中心静脉导管相关血流感染知识和行为的不足之处，以寻找解决对策，为下一步开展干预研究提供理论依据。方法在查阅相关文献基础上编制ICU护士预防中心静脉导管相关感染知识与行为问卷，并在进行Delphi专家咨询和信效度检测后，采用便利抽样法，整群抽取深圳市属6所三级综合医院成人ICU的护理人员进行问卷调查。结果136名护士参与了本次调查，职称、是否接受过中心静脉导管相关血流感染相关知识教育和科室是否有教育后的跟进措施和考核是影响护士中心静脉导管相关血流感染知识掌握情况的主要因素（P＜0.05）。护士预防中心静脉导管相关血流感染的行为得分为（3.83±0.92）分，是否接受过更换敷料的考核、科室是否有教育后的跟进措施和考核是行为得分的主要影响因素（P＜0.05）。护士的手卫生知识和行为呈负相关，相关系数为-0.549（P＜0.05）。结论 ICU护士对中心静脉导管相关血流感染预防与控制知识掌握不佳，行为水平有待加强，建议相关专业团体进行深入的研究，制定中心静脉导管相关血流感染标准操作流程和教育后的持续跟进措施。建议ICU管理者制定长效培训和跟进机制，加强行为依从性监控，提高护士的知识和行为水平，保障危重患者的静脉治疗安全。
목적：이《도관상관혈류감염예방여공제기술지남》적내용위의거，조사심수시속6소종합의원성인ICU호사예방중심정맥도관상관혈류감염지식화행위적현상，발현구역내종합의원ICU호사재예방중심정맥도관상관혈류감염지식화행위적불족지처，이심조해결대책，위하일보개전간예연구제공이론의거。방법재사열상관문헌기출상편제ICU호사예방중심정맥도관상관감염지식여행위문권，병재진행Delphi전가자순화신효도검측후，채용편리추양법，정군추취심수시속6소삼급종합의원성인ICU적호리인원진행문권조사。결과136명호사삼여료본차조사，직칭、시부접수과중심정맥도관상관혈류감염상관지식교육화과실시부유교육후적근진조시화고핵시영향호사중심정맥도관상관혈류감염지식장악정황적주요인소（P＜0.05）。호사예방중심정맥도관상관혈류감염적행위득분위（3.83±0.92）분，시부접수과경환부료적고핵、과실시부유교육후적근진조시화고핵시행위득분적주요영향인소（P＜0.05）。호사적수위생지식화행위정부상관，상관계수위-0.549（P＜0.05）。결론 ICU호사대중심정맥도관상관혈류감염예방여공제지식장악불가，행위수평유대가강，건의상관전업단체진행심입적연구，제정중심정맥도관상관혈류감염표준조작류정화교육후적지속근진조시。건의ICU관리자제정장효배훈화근진궤제，가강행위의종성감공，제고호사적지식화행위수평，보장위중환자적정맥치료안전。
Objective To investigate the knowledge and practice regarding preventing CLABSI (central-line-associated bloodstream infection) in adult ICU among Shenzhen municipal general hospitals and to provide reference for further intervention. Methods After review of relevant literature and expert consultation, a self-designed questionnaire about knowledge and behavior regarding preventing CLABSI of ICU nursing staff was designed. With cluster sampling, nurses from adult ICU in six general hospitals in Shenzhen were investigated with the self-designed questionnaire. Results Totally, 136 nurses participated in this survey and professional title, having training about knowledge of central venous catheter related bloodstream infection and follow-up measures after education were influence factors of nurses’ knowledge score (P<0.05). Nurses’ average behavior score for preventing central venous catheter related bloodstream infection was 3.83 ±0.92 and multiple linear stepwise regression analysis indicated that whether participating in central venous catheter dressing exchange test or not and follow-up measures after education were factors influencing behavior score (P<0.05). Hand hygiene knowledge was negatively related with nurses’ action (P<0.05). Conclusion Nurses’ knowledge regarding CLABSI prevention and control is poor and their behavior needs to be improved. The study suggests that multi-center research, qualification system for central venous catheter dressing replacement, sustainable educational programs and practice compliance monitoring for the nursing staff will benefit improving the theoretical knowledge and behavior and the safety of intravenous therapy in critical ill patients.