主管:国家卫生健康委员会
主办:国家卫生健康委医院管理研究所
中国科技核心期刊(中国科技论文统计源期刊)
中国科学引文数据库(CSCD)核心库期刊
《中文核心期刊要目总览》核心期刊

中国护理管理 ›› 2025, Vol. 25 ›› Issue (8): 1187-1193.doi: 10.3969/j.issn.1672-1756.2025.08.013

• 改善护理服务行动专题 • 上一篇    下一篇

疑似血流感染婴幼儿血培养标本规范采集的循证实践

蔡琦君 金玉梅 石芬芬 黄蓓丽 徐敏娟 严晶晶 柯叶芳 何鸯鸯   

  1. 宁波大学附属妇女儿童医院儿科病房,315012 浙江省宁波市(蔡琦君,石芬芬,黄蓓丽,何鸯鸯);护理部(金玉梅);新生儿监护病房(徐敏娟);公共卫生科(严晶晶);检验科(柯叶芳)
  • 出版日期:2025-08-15 发布日期:2025-08-15
  • 通讯作者: 金玉梅,硕士,主任护师,E-mail:mabel-299@163.com
  • 作者简介:蔡琦君,本科,主管护师,副护士长
  • 基金资助:
    第四轮宁波市医学重点扶植学科建设计划(2022-F26)

Evidence-based practice for standardization of blood culture specimen collection in infants and toddlers with suspected bloodstream infection

CAI Qijun, JIN Yumei, SHI Fenfen, HUANG Beili, XU Minjuan, YAN Jingjing, KE Yefang, HE Yangyang   

  1. Pediatric Ward, Women and Children's Hospital of Ningbo University, Ningbo, Zhejiang province, 315012, China
  • Online:2025-08-15 Published:2025-08-15
  • Contact: E-mail:mabel-299@163.com

摘要: 目的:将儿童血培养标本规范采集的证据应用于疑似血流感染的婴幼儿临床护理,并评价其应用效果,以促进证据向临床转化。方法:选取疑似血流感染婴幼儿和参与项目实施的15名护士为研究对象,其中2024年2月—3月的286例患儿为证据应用前组,2024年6月—7月的165例患儿为证据应用后组。根据汇总出的证据,制定相应的临床审查指标,逐条审查并运用i-PARIHS框架分析实施过程中的障碍因素,构建行动策略并进行实践变革。比较循证方案应用前后护士对审查指标的执行率和证据相关知识的知晓程度、患儿的血培养标本按时送达率和标本污染率。结果:证据应用后,15名护士血培养采集和运送的相关知识得分提高到90(80,90)分,审查指标的执行率提升至93.9%~100.0%;患儿血培养标本按时送达率提高到93.3%,标本污染率下降至0,差异均具有统计学意义(P<0.05)。结论:基于证据的循证实践可以有效规范医护人员的临床实践行为,提高检验分析前的标本质量。

关键词: 血培养;标本采集;血流感染;婴幼儿;循证实践

Abstract: Objective: To use the evidence to standardize blood culture collection for infants and toddlers with suspected bloodstream infection and assess its clinical effectiveness, in order to promote the translation of evidence into clinical practice. Methods: We selected infants and toddlers with suspected bloodstream infection who met the criteria and 15 nurses involved in the project as subjects. From February to March 2024, 286 patients were in the pre-evidence application group, and from June to July 2024, 165 patients were in the evidence application group. Based on the evidence, we set up clinical audit indicators and used the i-PARIHS framework to analyze implementation barriers and develop strategies for reform. Comparisons were made regarding the execution of audit indicators by nurses before and after the application of the evidence-based protocol, the knowledge level of nurses related to blood culture collection and transportation evidence; the proportion of specimens from collection to loading and incubation and the contamination rate of specimens of infants and toddlers. Results: After applying the evidence, the 15 nurses' knowledge scores on blood culture collection and transportation increased to 90 (80, 90), and the compliance rates of audit indicators rose to 93.9% to 100.0%. The proportion of specimens of infants and toddlers from collection to loading and incubation increased to 93.3%, and the contamination rate dropped to 0, with statistically significant changes (P<0.05). Conclusion: The evidence-based practice project can effectively standardize healthcare providers' practices in blood culture specimen collection, improving the pre-analytical quality of blood culture specimens.

Key words: blood culture; specimen collection; bloodstream infection; infant and toddler; evidence-based practice

中图分类号:  R47;R197