美国血管通路专科医生的培训、经验及实践：全国经外周静脉穿刺中心静脉置管调查结果
Vascular Access Specialist Training, Experience, and Practice in the United States: Results From the National PICC1 Survey.
作者信息
Chopra Vineet, Kuhn Latoya, Ratz David, Shader Scarlett, Vaughn Valerie M, Saint Sanjay, Krein Sarah L
机构信息
Division of General Medicine, University of Michigan Health System, Ann Arbor, Michigan (Drs Chopra, Shader, Vaughn, Saint, and Krein); Center for Clinical Management Research, VA Ann Arbor Healthcare System (Dr Chopra, Ms Kuhn, Mr Ratz, Drs Saint and Krein); Patient Safety Enhancement Program (PSEP), VA Ann Arbor Healthcare System/University of Michigan, Ann Arbor, Michigan (Dr Chopra, Ms Kuhn, Mr Ratz, and Drs Shader, Vaughn, Saint, and Krein). Vineet Chopra, MD, MSc, is an assistant professor of medicine and research scientist at the PSEP of the University of Michigan. Dr. Chopra's research interests focus on improving the use and safety of peripherally inserted central catheters in hospitalized patients. Latoya Kuhn, MPH, is a project manager and research area specialist in the PSEP of the VA Ann Arbor Healthcare System and the University of Michigan. Ms. Kuhn works closely with Drs. Chopra and Krein on research related to intravenous devices, including PICCs. David Ratz, MS, is a senior analyst and research area specialist in the PSEP of the VA Ann Arbor Healthcare System and the University of Michigan. Mr. Ratz works closely with Drs. Chopra and Krein on research related to PICCs. Scarlett Shader, BS, is a research assistant currently employed at the PSEP, University of Michigan. Ms. Shader is pursuing a master's degree at the University of Michigan School of Public Health while assisting the PSEP team with various projects including the PICC1 survey. Valerie M. Vaughn, MD, is a fellow in hospital medicine completing her training in health services research at the University of Michigan. Dr. Vaughn's research interests focus on preventing hospital-acquired complications such as catheter-related bloodstream infection and antibiotic-associated adverse events. Sanjay Saint, MD, MPH, is the George Dock Professor of Internal Medicine at the University of Michigan, the director of the VA/University of Michigan PSEP, and the chief of medicine at the VA Ann Arbor Healthcare System. Dr. Saint is an internationally recognized patient safety researcher. Sarah L. Krein, PhD, RN, is a research scientist at the VA Ann Arbor Healthcare System and a research professor of internal medicine with an adjunct appointment in the School of Nursing at the University of Michigan. Her research includes patient safety and improving inpatient care delivery.
出版信息
J Infus Nurs. 2017 Jan/Feb;40(1):15-25. doi: 10.1097/NAN.0000000000000203.
Vascular access specialists are increasingly responsible for insertion and care of peripherally inserted central catheters in the United States. Despite proliferation of the specialty, little is known about the training, practice patterns, and experiences of these clinicians. In partnership with a vascular access and an infusion nursing organization, a Web-based survey of 1698 clinicians was conducted. Substantial variation in practices related to insertion, use of technology, dressing and flushing, and management of complications was observed. Some reported practices were inconsistent with available evidence-based recommendations. Therefore, opportunities to improve patient care and further explore reasons driving such variation exist and should be explored.
在美国，血管通路专家越来越多地负责外周静脉置入中心静脉导管的插入和护理工作。尽管该专业不断发展，但对于这些临床医生的培训、实践模式和经验却知之甚少。与一个血管通路和一个输液护理组织合作，对1698名临床医生进行了一项基于网络的调查。结果发现，在导管插入、技术使用、敷料更换与冲管以及并发症管理等方面的实践存在很大差异。一些报告的做法与现有的循证推荐意见不一致。因此，存在改善患者护理的机会，并且应该进一步探究导致这种差异的原因。
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