Nursing Department, Peking University Shenzhen Hospital, Guangdong, China.
Renal Department, Peking University Shenzhen Hospital, Guangdong, China.
J Adv Nurs. 2021 May;77(5):2293-2306. doi: 10.1111/jan.14751. Epub 2021 Jan 11.
To investigate practice patterns in exit-site care and identify the risk factors for exit-site infection.
A quantitative cross-sectional design.
Data were collected in 12 peritoneal dialysis (PD) centres in 2018. Daily exit-site care practice patterns and exit-site status of patients receiving PD were assessed through interviews and questionnaires.
RESULTS/FINDINGS: Most of the 1,204 patients adhered with the protocols about main aspects of exit-site care, such as cleansing agents selection, frequency of cleansing, catheter fixation, and following the catheter protective measures. However, their adherence levels on hand hygiene, mask wearing, observing exit site, examining secretion, and communicating with PD staff were rather low. Eighty-four patients' exit sites were evaluated as problematic exit site (PES). And 186 patients had catheter-related infection (CRI) history. After multivariable logistic regression analysis, diabetes (OR = 1.631), traction bleeding history (OR = 2.697), antibiotic agents use (OR = 2.460), compliance on mask wearing (OR = 0.794), and observing exit site (OR = 0.806) were influencing factors of CRI history. Traction bleeding history (OR = 2.436), CRI history (OR = 10.280), and effective communication (OR = 0.808) with PD staff were influencing factors for PES.
The adherence levels on different aspects of exit-site care were varied in patients having PD. Their self-care behaviours did correlate with the exit-site status.
The adherence level of patients' exit-site care practice needs attention of medical staff. Further studies about the optimal procedure in exit-site care were warranted.
调查出口护理实践模式,并确定出口感染的危险因素。
定量横断面设计。
2018 年在 12 个腹膜透析(PD)中心收集数据。通过访谈和问卷评估接受 PD 的患者的日常出口护理实践模式和出口状况。
结果/发现:大多数 1204 名患者在出口护理的主要方面(如清洁剂选择、清洁频率、导管固定以及遵循导管保护措施)上遵守了方案。然而,他们在手部卫生、戴口罩、观察出口、检查分泌物以及与 PD 工作人员沟通方面的依从性较低。84 名患者的出口部位被评估为有问题的出口部位(PES)。186 名患者有导管相关感染(CRI)病史。多变量逻辑回归分析后,糖尿病(OR=1.631)、牵引性出血史(OR=2.697)、抗生素使用(OR=2.460)、戴口罩的依从性(OR=0.794)和观察出口(OR=0.806)是 CRI 病史的影响因素。牵引性出血史(OR=2.436)、CRI 病史(OR=10.280)和与 PD 工作人员的有效沟通(OR=0.808)是 PES 的影响因素。
接受 PD 的患者在出口护理的不同方面的依从性水平存在差异。他们的自我护理行为与出口状况相关。
患者出口护理实践的依从水平需要医务人员的关注。需要进一步研究出口护理的最佳程序。