| PurposeConstruct a PICC catheter care program for preterm infants,and discuss the application effect of PICC catheter care program for preterm infants in catheter protection for PICC catheter preterm infants,so as to provide theoretical and practical basis for further improving the nursing quality of PICC catheters in preterm infants.MethodThis study is divided into two parts.The first part: Establishing the goal-directed nursing program research group,based on literature review,combined with goal-directed theory and the use of PICC in preterm infants in clinical practice,formulate " PICC catheter care program for preterm infants(preliminary draft)",through the organization of expert group meetings to determine the final draft.The second part: Using convenience sampling method,80 preterm infants admitted to the Department of Neonatology in a three level of First-class Hospital of the region from July 2017 to July 2018 were selected as the study object.40 children admitted to the hospital from June to December 2017 who were implanted with PICC were set as the control group,and routine catheter care was carried out for the children in this group.40 children admitted to PICC from February to July 2018 were set as the observation group,after training nurses the PICC catheter care program was adopted for the group.Compared the two groups of PICC catheter displacement degree,catheter correction success rate,unplanned extubation rate,catheter-related infection rate.Results The first part :(1)Formed the Final draft of PICC Catheter Migration Risk Grade Assessment Form for Premature Infants.(2)Formed the PICC catheter care plan for premature infants(final draft).The second part :(1)Comparison of general information of children in the two groups: There was no significant difference in sex,gestational age,intubation age,birth weight and etiology between the two groups(P > 0.05),which was homogeneous.(2)Comparison of the degree of displacement of the PICC catheter between the two groups: 2 weeks after the catheter was placed,the chest radiographs of the tip of the PICC catheter of the two groups showed different degrees of displacement.The incidence of severe displacement in the observation group was 20%,and that in the control group was 40%,the degree of displacement between the two groups was significantly different(P<0.05);before extubation,30% of the last chest radiograph in the observation group showed moderate to severe displacement,and 70% of the control group experienced moderate to severe displacement.The degree of shift between the two groups was significantly different(P<0.05).(3)Comparison of PICC displacement correction results between the two groups: the catheter displacement rate in the observation group was 82.5%,and 100% of the catheter corrections were successful,of which the spontaneous correction success rate was 90.9%,the artificial correction success rate was 9.1%,and none of the catheters were reset;the control group catheter The displacement rate was 97.5%,92.3% was in orthodontic success,of which the spontaneous correction success rate was 71.79%,the artificial correction success rate was 20.51%,and the catheter replacement rate accounted for 7.7%.There was a significant difference in the displacement correction results between the two groups(P<0.05).(4)Comparison of PICC retention time between the two groups: During the period of catheter indwelling,there was no unplanned extubation in the observation group,the average indwelling time was(20.25 ± 7.66)days;the control group was 12.5%,the average indwelling time was(15.36 ± 7.92)days,the difference between the groups was statistically significant(P < 0.05).(5)Comparison of incidence rates of PICC catheter-related infections between the two groups: 7 days after catheter placement,the positive rate of bacterial culture in the observation group was 3.28%,no catheter-related infection occurred,the positive rate of bacterial culture in the control group was 1.56%,and the incidence of catheter-related infection was 1.56 %,no significant difference between the groups(P>0.05);14 days after tube placement,the positive rate of bacterial culture in the observation group was 1.56%,and there was no catheter-related infection.The positive rate of bacterial culture in the control group was 6.24%,and the catheter-related infection The incidence rate was 3.17%,and there was a significant difference in catheter-related infection rates between the two groups(P<0.05).ConclusionPICC catheter care program for preterm infants adopts unified,standardized and precise nursing measures,which provides a new model for PICC catheter care of preterm infants.Its clinical application can effectively prevent PICC catheter displacement,reduce the incidence of unplanned extubation and catheter-related infections,and has obvious advantages in improving the success rate of catheter positioning. |
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