Cluster Care In ICU Patients With Central Venous Catheters Application In Catheterization And Maintenance

Objective:To explore the role of cluster care in central venous catheter catheterization and maintenance in ICU.Methods:This study is an experimental study,based on the ICU of affiliated hospital of yan'an university as the research site.Eighty patients with central venous catheters were randomly selected.Divided into the control group and the experimental group of 40 cases each.In this study,patients in the control group were given routine care with central venous catheterization in ICU,Patients in the experimental group were given central venous catheter cluster nursing measures.The clustering measures include three parts:assessment before catheterization,specification of puncture process during catheterization,and maintenance after catheterization Data were collected by using the ICU central venous monitoring case questionnaire,APACHE II rating scale,and the implementation table of cluster nursing measures to observe the location of catheter,catheter indwelling time,number of cases of catheter infection,number of cases of complications of catheter indwelling,and length of stay in ICU through clinical observation,skynet system and blue dragonfly hospital infection monitoring system.All the data were input into Excel to establish a database,and SPSS22.0 was used for data analysis.The statistical description mainly adopts mean,standard deviation and percentage.Two independent samples t test and chi-square test were used for statistical analysis.Results:There is no significantly difference in statistics between the two groups of patients in gender,age,direct tube site and APACHE two scores(P>0.05),suggesting comparability.The incidence of central venous catheter-related bloodstream infection was 2.24‰in the experimental group and 20.98‰in the control group,The difference was statistically significant.(?~2=15.878,P<0.05).The catheter indwelling time was10.68±4.891 days in the experimental group and 7.15±2.824 days in the control group,The difference was statistically significant(t=-2.527,P<0.05).The length of stay was 9.68±4.994 days in the experimental group and 12.23±4.891 days in the control group,The difference was statistically significant(t=2.076,P<0.05).The incidence of central venous catheter complications was 12.50%in the experimental group and 35.00%in the control group,The difference was statistically significant(?~2=5.591,P<0.05).The rate of skin breakage caused by catheter indwelling was 5.00%in the experimental group and 12.50%in the control group,with no statistically significant difference(?~2=1.409,P>0.05).The blocking rate of central venous catheter in the experimental group was 5.00%,and that of the control group was 10.00%,with no statistically significant difference(?~2=0.721,P>0.05).The central venous catheter detachment rate was not 2.50%in the experimental group and 12.50%in the control group,with no statistically significant difference(?~2=2.883,P>0.05).Conclusion:In this study,the cluster nursing measures were formulated with pre-catheter evaluation,standardized puncture procedures and standardized catheter maintenance as the main body.The research confirmed that these measures are scientific,reasonable and feasible,and worthy of promotion.The application of cluster care in central vein catheterization and maintenance has obvious effect,cluster-based nursing measures reduce catheter-related bloodstream infection rates,and the incidence of catheter related complications,extend the time of catheter indwelling,shorten the length of hospital stay in ICU,Improve the dependence of the implementation measures of nurses,further optimize the nursing measures.