目的 经外周静脉穿刺中心静脉置管(peripherally-inserted central catheters,PICC)导管维护中存在的各种护理风险,会出现导管相关感染、血栓等并发症,造成非计划性拔管甚至危及患者生命.文中总结PICC风险管理的方法及效果.方法 通过对入选的416例患者风险识别、风险管理和风险评价,了解PICC维护期间并发症的发生率和患者满意率.结果 入选的416例带管患者中354例导管维护期间未发生并发症,识别并处理穿刺点感染24例、机械性静脉炎26例,发生堵管并有效处理,实现导管再通10例,发现置管手臂血栓患者2例,请医师协助溶栓治疗后拔管,无不良事件发生.患者、同行人员对服务质量满意率分别为99.7%、100.0%;对维护技术的满意率分别为99.7%、99.4%;对环境要求满意率分别为99.3%、95.3%.结论 实施PICC导管维护风险管理能有效避免维护期间并发症的发生,提高患者满意度.%Objective In the process of peripherally inserted central catheters (PICC) nursing, there may be the risks of complications including infection and thrombosis , which may harm the patient lives. The aim of this study is to explore the methods and effects of the risk management of PICC . Methods The incidence of complications and satisfaction rates of patients for PICC mainte -nance were collected through the identification and assessment of risks . Results Among the 416 PICC cases, no complications occurred in 354 cases during the catheter maintenance . Twenty-four cases with puncture site infection and 26 cases with mechanical phle -bitis were identified and treated. Pluggings occurred in 10 cases and were treated effectively with recanalization . Two cases of thrombosis were treated through thrombolytic therapy with no adverse events . Satisfaction rates on service quality from patients and health -care workers were 99.7% and 100% , respectively. Satisfaction rates on maintenance technology were 99.7% and 99.4% , respectively. Satisfaction rates on environment requirement were 99. 3% and 95. 3% , respectively. Conclusion The implementation of PICC maintenance risk management can reduce the incidence of maintenance complications and improve the satisfaction rates on the medical services.
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