复盘行动在减少住院患者PICC导管留置期间异位中的应用

doi:10.3969/j.issn.1672-1756.2017.10.029

复盘行动在减少住院患者PICC导管留置期间异位中的应用

许少媛翁桂珍刘丽娜林芳李春李永霞

福建医科大学附属协和医院肿瘤内科，350001福州市

出版日期:2017-10-25 发布日期:2017-10-25
基金资助:
国家临床重点专科建设项目（国卫办医函[2013] 544号）

Application of After-Action Review to prevent indwelling PICC dislodgement of inpatients

Online:2017-10-25 Published:2017-10-25

摘要/Abstract

摘要： 目的：分析复盘行动管理方法在减少住院患者PICC导管留置期间异位的应用效果。方法：建立复盘小组团队，于2015年10月至2016年2月，对肿瘤内科科留置PICC住院患者实施复盘行动管理方法，包括现况对比（衡量指标、目标回顾、现况把握）、情景重现（即时重现、阶段性重现、终末重现）、关键点法则（人员、技术、设备）、行动改进（宣教改革、袖口改良、维护技巧应用）、有效性验证及复盘归档6个步骤。结果：PICC导管异位率由复盘行动实施前的25.4%（46/181)下降至实施后的13.0%（28/215），差异具有统计学意义（χ2=9.930，P=0.002）。结论：复盘行动可明显降低住院患者PICC留置期间导管异位率，促进护士发现思维盲区，优化护理流程，为医院带来良好的长期效应，是一种不断自我进步的管理方法。

Abstract: Objective: To investigate the effect of After-Action Review (AAR) on preventing indwelling PICC dislodgement. Method: The AAR facilitators conducted inpatients' PICC management from October 2015 to February 2016. The initiative was composed of six steps, namely, comparison (assessment, goal review and discussion of current situation), scenario reconstruction (timely, staged and final reconstruction), key points (personnel, expertise and equipment), action improvement (reform of patient education, cuff improvement and maintenance skill), validation and documenting. Results: The rates of PICC dislodgement significantly decreased from 25.4% (46/181) to 13.0% (28/215), the differences of which were statistically significant (χ2=9.930, P=0.002). Conclusion: The findings suggest that After-Action Reviews constitute a specific venue through which nurses can decrease indwelling PICC dislodgement rates.

许少媛翁桂珍刘丽娜林芳李春李永霞. 复盘行动在减少住院患者PICC导管留置期间异位中的应用[J]. , 2017, 17(10): 1418-1422.