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预防外周静脉留置针感染的策略。

Strategies for preventing peripheral intravenous cannula infection.

作者信息

Morris Wendy, Heong Tay Mooi

机构信息

Royal Berkshire NHS Foundation Trust.

出版信息

Br J Nurs. 2008;17(19):S14-21. doi: 10.12968/bjon.2008.17.Sup8.31470.

Abstract

Peripheral intravenous (IV) cannulation is a procedure that involves breaching the integrity of the skin, exposing patients to the risk of infection. Acquisition of infection has associated costs both for patients and the NHS. The high number of peripheral IV cannulae (PICs) inserted annually has resulted in serious infection and significant morbidity (O'Grady et al, 2002). Risks associated with PIC infection must be addressed to reduce patient morbidity and increased cost of prolonged hospital admission and treatment. This article discusses the sources and routes of infection associated with peripheral IV cannulation, and examines healthcare management strategies for preventing infection when performing peripheral cannulation. These comprise: the Peripheral Venous Cannulation Policy, which empowers practitioners to challenge poor cannulation skills and standardize practice; education, which provides learning opportunities within programmes such as Infection Control Core Competencies Study Days, designed to promote infection prevention strategies directly related to cannula care and aimed at all levels of Trust staff; and the Peripheral Cannula Care Plan, which ensures accurate documentation of cannulation procedures. This last strategy is simple to use and provides a route for improving cannula-related documentation. A high standard of documentation will also assist audit, which is crucial to reducing PIC infection.

摘要

外周静脉置管是一种涉及破坏皮肤完整性的操作,会使患者面临感染风险。感染的发生对患者和英国国家医疗服务体系(NHS)而言都有相关成本。每年插入的外周静脉导管(PIC)数量众多,已导致严重感染和显著的发病率(奥格雷迪等人,2002年)。必须解决与PIC感染相关的风险,以降低患者发病率,并减少因延长住院时间和治疗而增加的成本。本文讨论了与外周静脉置管相关的感染源和感染途径,并探讨了在外周静脉置管时预防感染的医疗管理策略。这些策略包括:外周静脉置管政策,该政策使从业者能够对不良置管技能提出质疑并规范操作;教育,即在诸如感染控制核心能力学习日等项目中提供学习机会,这些项目旨在推广与导管护理直接相关的感染预防策略,并面向各级信托机构工作人员;以及外周导管护理计划,该计划确保准确记录置管程序。最后一项策略使用简单,并为改进与导管相关的记录提供了途径。高标准的记录也将有助于审计,这对减少PIC感染至关重要。

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