Petree Cindy, Wright Donna Lee, Sanders Vicki, Killion Jeff B
Radiology Associates of Indianapolis, Indiana, USA.
Radiol Technol. 2012 Jul-Aug;83(6):532-40.
Registered radiologist assistants (R.R.A.s) and other health care providers frequently are responsible for placing peripherally inserted central catheter (PICC) lines. Postprocedure blood stream infections are a potentially costly and medically serious complication.
To determine the most effective methods for R.R.A.s and other health professionals to reduce blood stream infections related to PICC line insertion and management.
Using specific inclusion criteria, the authors searched for scholarly reviewed articles related to PICC lines, infection, and adulthood.
The search produced 2237 articles, from which the authors selected 35 for review, in addition to 6 articles identified in the reference lists of articles not selected. The authors investigated 6 topics related to infection control in PICCs among nonimmunocompromised adults: securement devices, staff education, needleless systems, site preparation, maximum sterile barriers, and antimicrobial patches.
In the long run, proactive continuing education is less expensive than the cost of complications caused by postprocedure infections. Although further research is needed, specific strategies reported in the literature included prepping the skin using chlorhexidine and antimicrobial patches to reduce the microorganisms in the area. These steps should be followed by maximum sterile barriers. Needleless connectors and positive-pressure valves were found to be more effective than the alternatives, and proper securement with self-adhesive anchoring devices was found to be more effective than suturing for reducing blood stream infections.
注册放射技师助理（R.R.A.s）和其他医疗保健提供者经常负责放置外周静脉穿刺中心静脉导管（PICC）。术后血流感染是一种潜在成本高昂且在医学上较为严重的并发症。
确定R.R.A.s和其他卫生专业人员减少与PICC置管及管理相关血流感染的最有效方法。
作者使用特定纳入标准，搜索了与PICC、感染和成人相关的经学术评审的文章。
搜索产生了2237篇文章，作者从中选择了35篇进行综述，此外还从未入选文章的参考文献列表中确定了6篇文章。作者研究了非免疫功能低下成年人中与PICC感染控制相关的6个主题：固定装置、工作人员教育、无针系统、部位准备、最大无菌屏障和抗菌贴片。
从长远来看，积极的继续教育比术后感染引起的并发症成本更低。尽管还需要进一步研究，但文献中报道的具体策略包括使用氯己定和抗菌贴片准备皮肤以减少该区域的微生物。这些步骤之后应采用最大无菌屏障。发现无针连接器和正压阀比其他方法更有效，并且发现使用自粘固定装置进行适当固定比缝合在减少血流感染方面更有效。
