目的 探讨循环质控（Plan-Do-Check-Act,PDCA）理论下精准干预在血液恶性肿瘤（hematological malignancies,HM）患者经外周静脉置入中心静脉导管（peripherally inserted central catheter,PICC）置管化疗中的应用效果。方法 选取2022年2月—2024年5月在在本院收治的PICC置管化疗的HM患者143例,依据入组时间,将我院2022年2月—2023年3月收治的72例HM患者以及2023年4月—2024年5月收治的71例HM患者分别设为参考组和研究组。比较两组自我护理能力评分、疾病认知水平、护理质量评分、PICC留置时间及相关并发症、护理满意度评分。结果 干预2个月末,研究组自我护理能力量表的各维度（自我概念、自我责任感、健康知识、护理技能）评分高于参考组;研究组疾病认知水平各维度（疾病知识、药物使用、生活习惯、心理、并发症管理）评分高于参考组;研究组护理质量评分各维度（病区管理、基础护理、无菌管理、营养管理）得分高于参考组;研究组PICC留置时间较参考组明显延长,且PICC相关总并发症发生率低于参考组;干预2个月末,研究组护理满意度较参考组更高。结论 PDCA理论指导下精准干预可提高经PICC置管化疗的HM患者的自我护理能力,提升患者对疾病认知水平及护理质量,延长导管留置时间及降低并发症,进而提高护理满意度。
Abstract
Objective To investigate the application effect of precision intervention based on the Plan-Do-Check-Act (PDCA) theory in peripherally inserted central catheter (PICC) chemotherapy for patients with hematological malignancies (HM). Methods 143 HM patients admitted to our hospital for PICC catheterization chemotherapy from February 2022 to May 2024 were selected and grouped according to the time of enrollment, and 72 HM patients admitted to our hospital from February 2022 to March 2023 and 71 HM patients admitted to our hospital from April 2023 to May 2024 were set up as the reference group and the study group, respectively. The two groups were compared on self-care ability score, disease awareness level, nursing quality score, PICC indwelling time, related complications, and nursing satisfaction score. Results At the end of the 2-month intervention, the scores of each dimension (self-concept, self-responsibility, health knowledge, nursing skills) of the Self-Care Ability Scale in the study group were higher than those in the reference group. The scores of each dimension (disease knowledge, medication use, lifestyle habits, psychology, complication management) of disease cognition level in the study group were higher than those in the reference group. The scores of each dimension (ward management, basic nursing, aseptic management, nutritional management) of nursing quality in the study group were higher than those in the reference group. The dwell time of PICC in the study group was significantly longer than that in the reference group, and the total incidence of PICC-related complications was lower than that in the reference group. At the end of the 2-month intervention, the nursing satisfaction of the study group higher than that of the reference group. Conclusion Precision intervention under PDCA theory can improve self-care ability of patients undergoing PICC chemotherapy for HM, enhance the patients’ knowledge of the disease and nursing quality, prolong catheter indwelling time and reduce complications, thereby improving nursing satisfaction.
关键词
循环质控理论 /
精准干预 /
血液恶性肿瘤 /
PICC置管 /
化疗
Key words
Plan-Do-Check-Act theory /
precision intervention /
hematological malignancy /
peripherally inserted central catheter catheterization /
chemotherapy
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基金
山东省医药卫生科技项目“PICC导管在血液恶性肿瘤化疗中的应用及干预分析”（2024SDKY04011038）
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