经胸心内导管护理实践：国际基准研究。
Nursing Practice With Transthoracic Intracardiac Catheters in Children: International Benchmarking Study.
机构信息
Amy Jo Lisanti is a Ruth L. Kirschstein NRSA Postdoctoral Fellow at the University of Pennsylvania School of Nursing in Philadelphia and a clinical nurse specialist/nurse researcher at Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. Jamie Fitzgerald is a safety and quality specialist at Children's Hospital of Philadelphia. Stephanie Helman was a clinical nurse specialist at Children's Hospital of Philadelphia when the study was done. She is now a doctoral student at the University of Pittsburgh, Pittsburgh, Pennsylvania. Spencer Dean is a staff nurse in the cardiac intensive care unit at Children's Hospital of Philadelphia. Andrea Sorbello is a nurse practitioner and advanced practice provider team lead at Children's Hospital of Philadelphia. Heather Griffis is director of the Health Care Analytics Unit at Children's Hospital of Philadelphia.
出版信息
Am J Crit Care. 2019 May;28(3):174-181. doi: 10.4037/ajcc2019350.
BACKGROUND
Transthoracic intracardiac catheters are central catheters placed in the operating room at the conclusion of cardiac surgery for infants and children. Complications associated with these catheters (eg, bleeding, migration, premature removal, infection, leakage, and lack of function) have been described. However, no researchers have addressed the nursing management of these catheters in the intensive care unit, including catheter dressing and securement, mobilization of patients, and flushing the catheters, or the impact of these interventions on patients' outcomes.
OBJECTIVES
To internationally benchmark current nursing practice associated with care of infants and children with transthoracic intracardiac catheters.
METHODS
In a cross-sectional, descriptive study of nursing practice in infants and children with transthoracic intracardiac catheters, a convenience sample of bedside and advanced practice nurses was recruited to complete an online survey to benchmark current practice. The survey included questions on criteria for catheter insertion and removal, dressing care, flushing practice, securement, and mobilization of patients.
RESULTS
Transthoracic intracardiac catheters are used by most centers that provide care for infants and children after open heart surgery. A wide range of practices was reported.
CONCLUSIONS
Standardizing the use and care of transthoracic intracardiac catheters can improve the safety and efficacy of their use in infants and children and promote safe and early postoperative mobilization of patients.
背景
经胸心内导管是在心脏手术后的手术室中为婴儿和儿童放置的中央导管。与这些导管相关的并发症（例如出血、迁移、过早移除、感染、泄漏和功能丧失）已经被描述过。然而，没有研究人员针对重症监护病房中这些导管的护理管理（包括导管的包扎和固定、患者的活动以及导管的冲洗），或这些干预措施对患者结果的影响进行研究。
目的
在国际范围内为与经胸心内导管相关的婴儿和儿童护理建立当前护理实践的基准。
方法
在一项针对经胸心内导管婴儿和儿童护理的护理实践的横断面描述性研究中，招募了便利样本的床边和高级实践护士来完成在线调查，以建立当前实践的基准。该调查包括关于导管插入和移除标准、敷料护理、冲洗实践、固定和患者活动的问题。
结果
大多数为心脏直视手术后提供婴儿和儿童护理的中心都使用经胸心内导管。报告了广泛的实践。
结论
标准化经胸心内导管的使用和护理可以提高其在婴儿和儿童中的使用安全性和效果，并促进患者安全和早期术后活动。
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