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由护理专业人员主导的哥伦比亚一家高复杂性大学医院血管通路装置项目指标评估

Evaluation of Indicators of a Vascular Access Device Program led by Nursing Professionals in a High-complexity University Hospital in Colombia.

作者信息

Cortés Olga L, Parra Yeris M, Torres Daniela A, Monroy Patricia, Malpica Jannette C, Pérez Elena P, Mojica Carolina

机构信息

Fundación Cardioinfantil Instituto de Cardiología, la Cardio, Colombia,

出版信息

Invest Educ Enferm. 2022 Mar;40(1). doi: 10.17533/udea.iee.v40n1e12.

Abstract

OBJECTIVES

This work sought to evaluate result indicators of the specialized vascular access program led by nursing during the period between 01 January 2018 and 31 December 2019 at Fundación Cardioinfantil -Instituto de Cardiología (Colombia).

METHODS

This was a retrospective descriptive study based on medical records of 1,210 patients who received insertion of vascular access devices by the specialized group of nurses. Result indicators are described.

RESULTS

Of all the patients who received insertion of a vascular access catheter, 53.1% were women, with mean age of 34.2 years, admitted to critical care services with cardiovascular problems and sepsis (90.2%). Placement of the peripherally inserted central catheter, midline and arterial was echo-guided between 91% and 100%, with a success rate on the first puncture of 66%. The average duration time of the peripherally inserted central catheter was 25.3 days, that of the midline catheter was 8 days, with a reach of 57% until the end of the treatment. The rate observed per catheter-days of overall phlebitis was 2.03, for positive blood culture of the central peripheral insertion device was 1.9 and thrombosis of 0.50; and arterial line thrombosis was 11.7.

CONCLUSIONS

The Vascular Access Device Program led by nursing reported rational use of these elements with structured therapeutic purposes according with the complexity of the patients admitted to hospitalization. Improvement plans must be implemented to increase efficacy in post-admission insertion times, reduce infection rate and thrombosis through effective follow-up and control mechanisms.

摘要

目的

本研究旨在评估2018年1月1日至2019年12月31日期间,在哥伦比亚心血管儿童基金会-心脏病学研究所由护理团队主导的专业血管通路项目的结果指标。

方法

这是一项回顾性描述性研究,基于1210例接受专业护士团队插入血管通路装置的患者的病历进行。描述了结果指标。

结果

在所有接受血管通路导管插入的患者中,53.1%为女性,平均年龄34.2岁,因心血管问题和败血症入住重症监护病房(90.2%)。外周静脉穿刺中心静脉导管、中线导管和动脉导管的放置在91%至100%的情况下是在超声引导下进行的,首次穿刺成功率为66%。外周静脉穿刺中心静脉导管的平均留置时间为25.3天,中线导管为8天,直至治疗结束的成功率为57%。每导管日观察到的总体静脉炎发生率为2.03,外周中心静脉置管装置血培养阳性率为1.9,血栓形成率为0.50;动脉导管血栓形成率为11.7。

结论

由护理团队主导的血管通路装置项目报告称,根据住院患者的复杂程度,合理使用这些装置以达到结构化治疗目的。必须实施改进计划,以提高入院后插入时间的效率,通过有效的随访和控制机制降低感染率和血栓形成率。

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