关键词: 中心静脉导管相关血流感染；调查研究；护理；三级质控；医院感染与控制

Abstract: Objective: To explore the common issues in the tertiary quality control of Central Line-Associated Blood Stream Infections (CLABSI) in ICUs of tertiary grade A hospital, and to provide basis for further development of intervention measures and continuous improvement of nursing quality. Methods: Based on the Donabedian three-dimensional quality structure model and referring to the four guideline scales in the Quality Control Toolkit for the Prevention of Intravascular Catheter-related Bloodstream Infections (Recommended version), We make the questionnaire about the nursing pratices of the prevention and control of bloodstream infections associated with ICU central venous catheters. From September to October 2023, a questionnaire survey was conducted among the members of the hospital Infection Prevention and Control Committee of the Chinese Nursing Association and their organizations in the ICU of tertiary grade A hospital. Results: A total of 215 ICUs in 129 hospitals participated in the survey. Among the dimensions of nursing practice structure, 156 ICUs (72.56%) conducted regular sensory control training. In the process dimension, the nurse implementation rate was lower than 80% in 9 projects (28.13%), of which 52 ICUs (24.19%) used ultrasound guidance during CVC puncture, 59 ICUs (27.44%) used the guideline recommended Selectol fixed catheter, and 55 ICUs (25.58%) used glucochlorhexidine antibacterial dressing. The incidence of CLABSI was reported in 193 ICUs (89.77%). Conclusion: At present, the structure, process, and results of CLABSI focused catheter catheterization and maintenance for prevention and control are involved, but it is found that no homogeneous prevention and control measures have been formed in clinical practice. It is suggested to further strengthen the process quality control management to better improve the quality of nursing.

Key words: Central Line-Associated Blood Stream Infection; cross-sectional survey; nursing; tertiary quality control; hospital infection and control