Abstract:

Objective　To analyze the effect of PDCA care on reducing peripherally inserted central catheter (PICC)-associated infection in elderly tumor patients. Methods　This was a prospective study. One hundred and ten elderly tumor patients treated at Inner Mongolia People's Hospital from October 2020 to October 2021 were selected as the study objects. They were divided into a control group and a study group by the double chromosphere method, with 55 cases in each group. There were 15 males and 40 females in the control group; they were 65-85 (75.36±1.25) years old. There were 13 males and 42 females in the study group; they were 65-84 (75.23±1.14) years old. The control group took routine care, and the study group PDCA care. The subjective feelings and emotions, the retention times and placement of PICC, the incidences of complications of PICC catheterization, and the nursing compliance were compared between the 2 groups. χ² and t teste were applied. Results　After the intervention, the scores of depression, anxiety, and stress in the study group were lower than those in the control group [(2.03±0.45) vs. (2.31±0.52), (2.04±0.36) vs. (2.23±0.23), and (1.85±0.41) vs. (2.05±0.35)], with statistical differences (t=3.020, 3.298, and 2.751; all P<0.05). The retention time of PICC, catheter blockage times, and catheter shedding times in the study group were better than those in the control group [(25.34±4.26) d vs. (22.52±4.25) d, (4.75±1.12) times vs. (5.52±1.24) times, and (3.85±1.24) times vs. (4.63±1.52) times], with statistical differences (t=3.475, 3.418, 2.949; all P<0.05). The incidence of PICC-related infection, mechanical phlebitis, puncture point bleeding, and thrombotic complication in the study group was lower than that in the control group [3.64% (2/55) vs. 14.55% (8/55)], with a statistical difference (χ²=3.960, P<0.05). The nursing compliance in the study group was higher than that in the control group [98.18% (54/55) vs. 87.27% (48/55)], with a statistical difference (χ²=4.853, P<0.05). Conclusion　PDCA care for elderly tumor patients taking PICC can effectively improve their subjective feelings and compliance, and reduce the adverse reactions, catheterization retention time, and incidence of complications during the catheterization period.

Key words:

Peripherally inserted central catheter, Catheter-related infection, PDCA care, Tumors, The elderly

摘要：

目的　分析对经外周静脉穿刺中心静脉置管（PICC）老年肿瘤患者应用PDCA护理对其感染发生率的作用。方法　选取内蒙古自治区人民医院2020年10月至2021年10月期间收治的110例老年肿瘤患者作为研究对象，研究类型为前瞻性研究，应用双色球法分为对照组及研究组，各55例。对照组男15例，女40例，年龄65～85（75.36±1.25）岁，实施常规护理；研究组男13例，女42例，年龄65～84（75.23±1.14）岁，行PDCA护理。对两组干预前后主观感受情绪、PICC置管滞留时间及置管情况、PICC置管并发症发生率、护理依从性进行对比。统计学方法采用χ²检验、t检验。结果　干预后，研究组负面情绪（抑郁、焦虑、应激）评分均低于对照组［（2.03±0.45）分比（2.31±0.52）分、（2.04±0.36）分比（2.23±0.23）分、（1.85±0.41）分比（2.05±0.35）分］，差异均有统计学意义（t=3.020、3.298、2.751，均P<0.05）；研究组PICC置管滞留时间、导管堵塞次数、导管脱落次数均优于对照组［（25.34±4.26）d比（22.52±4.25）d、（4.75±1.12）次比（5.52±1.24）次、（3.85±1.24）次比（4.63±1.52）次］，差异均有统计学意义（t=3.475、3.418、2.949，均P<0.05）；研究组PICC相关感染、机械静脉炎、穿刺点出血、血栓并发症总发生概率低于对照组［3.64%（2/55）比14.55%（8/55）］，差异有统计学意义（χ²=3.960，P<0.05）；研究组护理依从性高于对照组［98.18%（54/55）比87.27%（48/55）］，差异有统计学意义（χ²=4.853，P<0.05）。结论　老年肿瘤患者PICC后应用PDCA护理，可有效提升老年肿瘤患者置管期间的主观感受情绪，并降低不良反应和置管滞留时间，减少置管期间并发症发生率，提升患者置管依从性。

关键词:

经外周静脉穿刺中心静脉置管, 导管相关性感染, PDCA护理, 肿瘤, 老年