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心内科病房外周置入中心静脉导管置管:护士观点的焦点小组研究。

Peripherally Inserted Central Catheter Placement in a Cardiology Ward: A Focus Group Study of Nurses' Perspectives.

机构信息

The Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3004-011 Coimbra, Portugal.

Coimbra Hospital and Universitary Centre-General Hospital, 3041-801 Coimbra, Portugal.

出版信息

Int J Environ Res Public Health. 2021 Jul 17;18(14):7618. doi: 10.3390/ijerph18147618.

Abstract

Intravenous therapy administration through peripheral venous catheters is one of the most common nursing procedures performed in clinical contexts. However, peripherally inserted central catheters (PICC) remain insufficiently used by nurses and can be considered a potential alternative for patients who need aggressive intravenous therapy and/or therapy for extended periods. The purpose of this study was to understand nurses' perspectives about PICC implementation in their clinical practice. As part of an action-research project, three focus groups were developed in June 2019 with nineteen nurses of a cardiology ward from a Portuguese tertiary hospital. From the content analysis, two main categories emerged: 'nursing practices' and 'patients'. Nurses considered PICC beneficial for their clinical practice because it facilitates maintenance care and catheter replacement rates. Moreover, nurses suggested that, since there is a need for specific skills, the constitution of vascular access teams, as recommended by international guidelines, could be an advantage. Regarding patient benefits, nurses highlighted a decrease in the number of venipunctures and also of patient discomfort, which was associated with the number of peripheral venous catheters. Infection prevention was also indicated. As an emerging medical device used among clinicians, peripherally inserted central catheters seem to be essential to clinical practice.

摘要

经外周静脉置入中心静脉导管(PICC)的静脉治疗给药是临床护理中最常见的操作之一。然而,护士对 PICC 的使用率仍然较低,对于需要积极静脉治疗和/或长时间治疗的患者,PICC 可被视为一种潜在的选择。本研究旨在了解护士在临床实践中对 PICC 应用的看法。作为行动研究项目的一部分,2019 年 6 月,在一家葡萄牙三级医院的心内科病房,通过 3 个焦点小组,对 19 名护士进行了调查。从内容分析中,出现了两个主要类别:“护理实践”和“患者”。护士认为 PICC 对他们的临床实践有益,因为它可以方便维持护理和导管更换率。此外,护士建议,由于需要特定的技能,因此可以按照国际指南的建议,组成血管通路团队。关于患者的益处,护士强调了静脉穿刺次数和患者不适的减少,这与外周静脉导管的数量有关。预防感染也被提及。作为一种在临床医生中使用的新兴医疗器械,经外周静脉置入中心静脉导管似乎对临床实践至关重要。

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