PDCA护理模式在宫颈癌晚期患者PICC置管中的应用(1)
【摘 要】目的：对循环质量管理(plan-do-check-action，PDCA)护理模式在宫颈癌晚期患者经外周静脉置入中心静脉导管(PICC)置管及护理过程中的效果进行评价分析。方法：选取2014年—2015年在第三军医大学大坪医院进行PICC置管，并应用PDCA护理模式进行护理管理的宫颈癌晚期患者50例作为观察组，选取作2013-2014年该院行PICC置管，行PICC常规护理管理的宫颈癌晚期患者49例为对照组，观察并统计两组患者PICC置管一次成功率，相关并发症发生情况，导管留置时间以及患者的满意度。结果：观察组PICC置管一次成功率为96.00%，对照组PICC置管一次成功率为75.51%；观察组相关并发症发生率为12.00%， 对照组相关并发症发生率为38.78%；观察组留置时间为136.06±14.58天， 对照组为112.16±15.62天；观察组满意率为90.00%， 对照组满意率为71.43%，上述各项比较差异均具有统计学意义 P<0.05。结论：在宫颈癌晚期患者PICC置管过程中的应用PDCA护理模式能显著提高穿刺成功率，减少PICC置管过程中的相关并发症，延长PICC置管时间，提高患者的满意度。
, http://www.100md.com
【关键词】PDCA，护理，PICC置管， 宫颈癌
Abstract：Objective To evaluate the effect of PDCA model in PICC catheter nursing for patients with late cervical cancer. Methods 50 patients with late cervical cancer accepted PICC from 2014 to 2015 in Daping Hospital of Chongqing， were treated with PDCA model nursing， as experimental group； another 49 cases with late cervical cancer accepted PICC from 2013 to 2014， were treated with routine nursing， as control group. Success rate for the first time puncture and occurrence rate of complications as well as the keeping time of catheter in two groups were observed； satisfaction rate of nursing were carried out after nursing. Results In experimental group， success rate for the first time puncture was 96.00%，and in control group it was 75.51%. In experimental group， the complication rate was 12.00% ，and in control group the complication rate was 38.78%. In experimental group ， the keeping time of catheter was 136.06±14.58 days， and in control group the keeping time of catheter was 112.16±15.62 days. The satisfaction rate of experimental group was 90.00%， and the control group was 80.9%.All of the above were compared， the differences were statistically significant (P< 0.05). Conclusion PDCA model applied in the PICC catheter nursing of patients with late cervical cancer can significantly improve the success rate of the first puncture ， reduce the patients' catheter complications， increase the keeping time of catheter ，at the same time patients' satisfaction rate was higher than usual.
, http://www.100md.com
Key words：PDCA model； nursing； PICC catheter；
【中圖分类号】R473.73 【文献标识码】A 【文章编号】1005-0019(2018)01-0-01
宫颈癌是妇科最常见的恶性肿瘤，发病率居女性生殖器官肿瘤的首位，且呈年轻化及上升趋势[1]。由于晚期宫颈癌失去了最佳手术切除时机，故需进行多疗程化疗，目前临床上多采取经外周静脉置入中心静脉导管(PICC)的方法进行化疗给药。PICC是利用导管对外周手臂的静脉进行穿刺，导管可直达靠近心脏的大静脉的一种导管置入方法。利用这种方法可避免化疗药物与外周静脉的直接接触，加之大静脉的血流速度较快，可以迅速稀释化疗药物，防止药物对血管的刺激，因此能够有效保护上肢静脉，减少静脉炎等并发症的发生，减轻患者的痛苦，提高患者的生活质量[2-3]。自20世纪80年代以来，PICC置管在患者中的应用越来越广泛，主要用于中长期化学治疗、肠外营养输注或抗菌治疗[4-5]，相对于传统的穿刺输液， PICC能避免反复穿刺给患者带来的不良后果， 具有留置时间长， 置管成功率高， 安全有效的优点[6]，是一种方便可靠和科学的静脉通路。但是PICC是经皮外静脉插管，对初学者及临床经验较少者操作和护理难度较大，其常见问题及并发症比较多[7-9]，如处理不当，甚至会发生严重后果，为此我们近年来尝试采用PDCA护理模式来贯穿PICC置管护理的全过程，已初见成效，现简介如下。, http://www.100md.com(刘水霞 刘红 蒋远静)
, http://www.100md.com
【关键词】PDCA，护理，PICC置管， 宫颈癌
Abstract：Objective To evaluate the effect of PDCA model in PICC catheter nursing for patients with late cervical cancer. Methods 50 patients with late cervical cancer accepted PICC from 2014 to 2015 in Daping Hospital of Chongqing， were treated with PDCA model nursing， as experimental group； another 49 cases with late cervical cancer accepted PICC from 2013 to 2014， were treated with routine nursing， as control group. Success rate for the first time puncture and occurrence rate of complications as well as the keeping time of catheter in two groups were observed； satisfaction rate of nursing were carried out after nursing. Results In experimental group， success rate for the first time puncture was 96.00%，and in control group it was 75.51%. In experimental group， the complication rate was 12.00% ，and in control group the complication rate was 38.78%. In experimental group ， the keeping time of catheter was 136.06±14.58 days， and in control group the keeping time of catheter was 112.16±15.62 days. The satisfaction rate of experimental group was 90.00%， and the control group was 80.9%.All of the above were compared， the differences were statistically significant (P< 0.05). Conclusion PDCA model applied in the PICC catheter nursing of patients with late cervical cancer can significantly improve the success rate of the first puncture ， reduce the patients' catheter complications， increase the keeping time of catheter ，at the same time patients' satisfaction rate was higher than usual.
, http://www.100md.com
Key words：PDCA model； nursing； PICC catheter；
【中圖分类号】R473.73 【文献标识码】A 【文章编号】1005-0019(2018)01-0-01
宫颈癌是妇科最常见的恶性肿瘤，发病率居女性生殖器官肿瘤的首位，且呈年轻化及上升趋势[1]。由于晚期宫颈癌失去了最佳手术切除时机，故需进行多疗程化疗，目前临床上多采取经外周静脉置入中心静脉导管(PICC)的方法进行化疗给药。PICC是利用导管对外周手臂的静脉进行穿刺，导管可直达靠近心脏的大静脉的一种导管置入方法。利用这种方法可避免化疗药物与外周静脉的直接接触，加之大静脉的血流速度较快，可以迅速稀释化疗药物，防止药物对血管的刺激，因此能够有效保护上肢静脉，减少静脉炎等并发症的发生，减轻患者的痛苦，提高患者的生活质量[2-3]。自20世纪80年代以来，PICC置管在患者中的应用越来越广泛，主要用于中长期化学治疗、肠外营养输注或抗菌治疗[4-5]，相对于传统的穿刺输液， PICC能避免反复穿刺给患者带来的不良后果， 具有留置时间长， 置管成功率高， 安全有效的优点[6]，是一种方便可靠和科学的静脉通路。但是PICC是经皮外静脉插管，对初学者及临床经验较少者操作和护理难度较大，其常见问题及并发症比较多[7-9]，如处理不当，甚至会发生严重后果，为此我们近年来尝试采用PDCA护理模式来贯穿PICC置管护理的全过程，已初见成效，现简介如下。, http://www.100md.com(刘水霞 刘红 蒋远静)
参见：首页 > 医疗版 > 疾病专题 > 妇产科 > 女性生殖器官肿瘤及肿瘤样病变 > 子宫颈癌