New Karen A, Webster Joan, Marsh Nicole M, Hewer Barbara
Centre for Clinical Nursing, 2nd Floor, Centre for Clinical Nursing, Building 34, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Qld 4029, Australia. Email: ; ;
Aust Health Rev. 2014 Jun;38(3):345-9. doi: 10.1071/AH13111.
To examine the use, management, documentation and complications for intravascular devices in cardiac, medical and surgical inpatients.
A point prevalence survey was undertaken in a large tertiary hospital in Queensland. Descriptive statistics were used to analyse data.
Of the 327 patients assessed, 192 (58.7%) had one or more devices in situ. Of the 220 devices, 190 (86.4%) were peripheral venous catheters, 25 (11.4%) were peripherally inserted central catheters and five (2.3%) were central venous catheters. Sixty-two of 220 devices (28.2%) were in situ without a clear purpose, whereas 54 (24.7%) had one or more complications, such as redness, pain, tracking, oedema or oozing. There was no documentation on the daily patient care record to indicate that a site assessment had occurred within the past 8h for 25% of the devices in situ.
The present study identified several problems and highlighted areas for improvement in the management and documentation for intravascular devices. Ongoing education, promoting good clinical practice and reauditing, can be applied to improve the management of devices.
研究心脏科、内科及外科住院患者血管内装置的使用、管理、记录情况及并发症。
在昆士兰州一家大型三级医院开展了一项现患率调查。采用描述性统计方法分析数据。
在评估的327例患者中,192例(58.7%)体内有一个或多个装置。在220个装置中,190个(86.4%)是外周静脉导管,25个(11.4%)是外周置入中心静脉导管,5个(2.3%)是中心静脉导管。220个装置中有62个(28.2%)留置但目的不明确,54个(24.7%)出现一种或多种并发症,如发红、疼痛、条索状、水肿或渗液。在日常患者护理记录中,25%的留置装置在过去8小时内未记录有进行过部位评估。
本研究发现了血管内装置管理和记录方面的若干问题,并突出了需要改进的领域。持续教育、推广良好的临床实践及重新审核可用于改善装置管理。