Construction and Application Evaluation of Lean Management Plan for Children's Midline Catheter
Objective To construct a lean management plan for children's midline catheters and explore its effectiveness in the placement and maintenance of midline catheters in children.Methods On the basis of literature reviewed and clinical experience summaried,the lean management model was used as the framework.The issues encountered during the placement and maintenance of children's midline catheters were summarized,and a preliminary draft of a lean management plan for children's midline catheters developed.Then,the final draft through group discussion were determined.A non-synchronous controlled experiment was used,87 children with indwelling midline catheters in a pediatric ward of a tertiary hospital in Henan Province from January to September 2021 were reviewed as the control group.From October 2021 to July 2022,lean management was implemented,and a total of 96 children were included as the experimental group.The success rate of the first puncture,the number of punctures used for successful catheterization and the incidence of catheter related thrombosis between the two groups of children were compared.Results The success rate of the first puncture was 71.88％in the experimental group and 55.18％in the control group(x2=5.522,P＜0.05).The number of punctures used for successful catheterization in the experimental group was(1.56±0.53)and(2.81±0.85)in the control group(t=11.792,P＜0.05).The incidence of catheter related thrombosis was 5.21％in the experimental group and 16.09％in the control group(x2=8.310,P＜0.05).Conclusion The lean management plan for pediatric midline catheters can effectively improve the success rate of the first puncture of pediatric midline catheterization,reduce the number of punctures,and effectively reduce the risk of catheter-related thrombosis.It can be promoted and applied in clinical practice.
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