目的：探讨由具有PICC置管资质的主管护师及以上护士对不具备置管资质护士进行一对一式培训考核、安排考核合格具有科室PICC护理资质的护士担任此类患儿的责护对降低新生儿PICC非正常拔管率的效果。方法2013年9月以前我科实行全科护士均可担任PICC患儿责护，采取传统的集中培训模式培训PICC维护，选取新生儿科2012年5月至2013年9月期间的118例PICC置管患儿作为对照组；2013年9月起我科采用一对一培训模式培训PICC维护，通过考核护士获得科室PICC护理资质，担任PICC患儿的责任护士，选取我科2013年10月至2014年5月122例PICC置管患儿作为观察组，对比分析两组患儿PICC非正常拔管率之间的差异。结果新生儿PICC非正常拔管率由对照组的14．41％降低到观察组的3．28％。两组非正常拔管率有显著差异（ P＜0．05）。结论采用一对一培训模式联合PICC置管患儿责任护士准入制管理模式可以降低新生儿PICC非正常拔管率。%Objective Investigate the effect of responsibility nurse 's access system in reducingneonatal abnormal extubation rate .Methods All the nurses in our department can act as responsibility nursefor children with PICC tube before Sep 2013, and they were trained by using traditional centralized training model .118 cases of children with PICC catheter duringMay 2012 and Sep 2013 were enrolled as control group .However , this strategy was modified after Sep 2103,responsibility nursein our department received one -on-one training for PICC conducting , andonly the nurses who got PICC intelligence can provide nursing service for children with PICC catheter, totally 122 cases of children with PICC catheter in our hospitalduring Oct 2013 and May 2014 were chosen as observation group .Compared the occurrenceof neonatal abnormal extubation betweenthe two groups . Results PICC non-planned decannulation rate decreased of the control group was 14.41%, however, the rate of the observationgroup was 3.28%.There is significant difference between the two groups of non -planned decannulation rate (P<0.05).Conclusions One to one training combined with PICC catheter in children with responsibility nurse 's access system can reduce neonatal abnormal extubation rate .
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