关键词: 经外周静脉置入中心静脉导管；非计划拔管；数据驱动决策；血液病；六西格玛

Abstract: Objective: To construct a data-driven decision-making-based management model for unplanned extubation of Peripherally Inserted Central Catheters (PICC) and evaluate its effects, in order to provide evidence for refined quality management. Methods: Guided by the Six Sigma framework, a data-driven decision-making-based model for PICC unplanned extubation among patients with hematological diseases was developed through clinical investigation and expert discussion, and implemented from October 2024. Nurses' knowledge scores of PICC unplanned extubation prevention, process quality inspection scores, PICC-related risk information awareness rates, and the incidence of unplanned extubation in patients were compared before and after the model implementation. The U control chart was used to monitor the stability of intervention effects. Results: After the model implementation, nurses' knowledge scores of PICC unplanned extubation prevention increased from 71.62±15.75 to 82.54±10.81 (P<0.001). Process quality inspection scores and PICC-related risk information awareness rates were also improved (P<0.001), and the incidence of PICC unplanned extubation remained at a low level for 6 consecutive months. Conclusion: The model can improve nurses' knowledge regarding PICC unplanned extubation, and enhance their risk perception and capability for process quality control, providing a reference for data-based lean management of central venous catheters.

Key words: Peripherally Inserted Central Catheter; unplanned extubation; data-driven decision-making; hematological disease; Six Sigma