中国血液净化

中国血液净化 ›› 2019, Vol. 18 ›› Issue (05): 345-348.doi: 10.3969/j.issn.1671-4091.2019.05.016

• 护理研究 • 上一篇    下一篇

北京地区腹膜透析护士外出口护理和培训实践现状调查

秦锦1,孙庆华1,苏春燕1,郭桂芳2   

  1. 1. 北京大学第三医院肾内科
    2. 北京大学护理学院
  • 收稿日期:2018-12-03 修回日期:2019-02-28 出版日期:2019-05-12 发布日期:2019-05-15
  • 通讯作者: 苏春燕 scybmu@126.com E-mail:scybmu@126.com
  • 基金资助:

    北京大学护理学院郎泰护理科研基金：腹膜透析患者出口处护理规范的建立(LTHL17ZD06)；
    深圳市卫生计生系统科研项目，腹膜透析患者导管出口处护理现状的多中心调查分析(SZXJ2017016)

Nursing and training of exit-site care in nurses working for peritoneal dialysis patients in Beijing

  • Received:2018-12-03 Revised:2019-02-28 Online:2019-05-12 Published:2019-05-15

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摘要： 【摘要】目的调查北京市设有中心的医院腹膜透析专职护士导管外出口护理操作和外出口护理培训的现状。方法自制《腹膜透析导管外出口护理实践调查表》，对北京市17 家医院34 名腹膜透析专职护士进行调查。结果所调查医院导管相关感染的发病率为0.05 次/年，护患比约为1：46.15。97.06%护士能够注意无菌操作，91.18%能够按完成外出口评估；26 名护士选择生理盐水+碘伏的消毒方式。培训内容中换药频率为外出口成熟前后约有50%为每周2 次，其他频率更为频繁；只有4 名护士会要求患者常规使用抗菌软膏预防感染。整体培训情况为，每名患者接受培训平均为(16.96±9.95)h，所有护士都会对患者进行操作再培训，无人进行家访。结论腹膜透析专科护士在操作情况和培训情况2方面均能较好地按照《国际腹膜透析协会导管相关性感染指南》建议去进行实践，是否使用抗菌软膏预防感染与《指南》存在差异。

关键词: 腹膜透析, 护士, 导管相关性感染, 外出口护理, 培训

Abstract: 【Abstract】Objective To investigate nursing and training of exit-site care for peritoneal dialysis (PD) patients in professional nurses working in the PD centers in Beijing. Methods This was a cross- sectional study. A self-designed questionnaire of“Investigation on Nursing Practice of Exit-site Care for PD Patients” was used to investigate 34 professional PD nurses from 17 hospitals in Beijing. Results The incidence of exit-site infection was 0.05 episode/ patient/year in these hospitals. The number of nurse-to-patient ratio was 1: 46.15. Thirty-three nurses (97.06%) could strictly follow the aseptic manipulation; 91.18% of the nurses were able to complete the exit- site assessment; 26 nurses used normal saline plus iodophor to disinfect the exitsites. About 50% of the nurses trained the patients or their caregivers to do exit-site care twice a week around the period of exit-site maturation. Only 4 nurses trained the patients to routinely use antibacterial ointment to prevent exit-site infection. The training time was 16.96±9.95 hours for new patients. All nurses re-trained exitsite care in the patients, but no one did home visit. Conclusion The exit-site care practice and training following the ISPD guidelines were well conducted in professional PD nurses. The use of antibacterial ointment to prevent infection was different from the ISPD guidelines. Further investigation in this area is warranted.

Key words: Peritoneal dialysis, Nurse, Catheter-related infections, Exit-site care, Training