英文摘要
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Intravenous catheters are commonly used for drug administration, nutritional infusion, intravenous infusion, and the monitoring of hemodynamics. After a clinical venous catheter is inserted in the patient, bacteria can easily enter the blood vessel through the catheter and cause a blood infection. Such infections often lead to prolonged hospitalization and a high risk of death. We found that the venous catheter-related blood infection rate was high in our medical ward. Patients often experienced uncomfortable symptoms, such as vasculitis and pain at the injection site. In addition, such infections can cause patients to have fever, delay discharge, increase the number of days in hospital, and reduce the quality of nursing care. Therefore, we gathered a project team to improve the current situation. After much discussion, a cross-departmental team implemented improvement measures. These included a comprehensive review of the venous catheter placement procedure, strict adherence to the principle of sterility, use of a catheter placement flowchart reminder card, integration of a catheter placement checklist, reeducation of medical staff to reinforce behaviors and change habits leading to errors, regularly checking the effectiveness of the implementation, providing timely feedback on both sides, and other improvement measures. After the implementation of the project, the accuracy rate of venous catheter placement and care by the medical staff of the unit increased from 74% to 94%, and the venous catheter-related blood infection rate decreased from 0.88% to 0.43%. This project has reached its goal. Therefore, we proposed to share these improvement measures with the medical staff.
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参考文献
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連結:
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連結:
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連結:
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Alexandrou, E., RayBarruel, G., Carr, P. J., Frost, S., Inwood, S., Higgins, N., … & Rickard, C. M. (2015). International prevalence of the use of peripheral intravenous catheters. Journal of Hospital Medicine, 10(8), 530–533.
連結:
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Schuster, C., Stahl, B., Murray, C., Keleekai, N., & Glover, K. (2016). Development and testing of a short peripheral intravenous catheter insertion skills checklist, Journal of the Association for Vascular Access; Clinton, 21(4), 196–204.
連結:
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衛生福利部疾病管制署(2017).新版監測定義-第二章 血流感染(中心導管相關血流感染和非中心導管 相關血流感染)。 https://www.cdc.gov.tw/File/Get/- KOnm3zbS_OzxLa4WEs_BQ
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Devesty, G., Schub, T., & Pravikoff, D. (2019). Central venous catheters: using - an overview. Nursing Reference Center Plus. http://web-ebscohost-com.erm.cch.org.tw:3000/nup/detail/ detail?vid=3&sid=72a47122-d997-49ab-988f-93f2e3622c93%40pdc-v-sessmgr02&bdata=JnNpdG U9bnVwLWxpdmUmc2NvcGU9c2l0ZQ%3d%3d# AN=T707184&db=nup
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Erdogan, B. C. (2016). The development of phlebitis and infiltration in patients with peripheral intravenous catheters in the neurosurgery clinic and affecting factors. International Journal of Caring Sciences, 9(2), 619–629. https://www.proquest.com/scholarljournals/development-phlebitis-infiltration-patients- with/docview/1817087829/se-2?accountid=7266
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Gillian, R. B. (2017). Infection prevention: peripheral intravenous catheter assessment and care. Australian Nursing and Midwifery Journal, 24(8), 34. https://www.proquest.com/scholarly-journals/ infection-prevention-peripheral-intravenous/ docview/1875059223/se-2?accountid=7266
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Schub, T., Caple, C., & Pravikoff, D. (2017). Peripheral IV (PIV) catheter: winged needle catheter Insertion. Nursing Reference Center Plus. http://web--ebscohost-com.erm.cch.org.tw:3000/nup/detail/
detail?vid=6&sid=72a47122-d997-49ab-988f 93f2e3622c93%40pdc-v-sessmgr02&bdata=JnNpdG
U9bnVwLWxpdmUmc2NvcGU9c2l0ZQ%3d%3d#AN=T705623&db=nup
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