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儿童中心静脉血管通路装置安全管理信息化平台的构建与应用

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目的:构建基于循证的儿童中心静脉血管通路装置(Central Venous Access Devices,CVADs)安全管理信息化平台(以下简称平台),并评价其应用效果.旨在促进证据临床转化,降低导管相关并发症,提高导管安全管理水平.方法:系统检索儿童CVADs置入、维护、拔除等方面文献,提取具体措施后,组织人员进行论证,并制定嵌入信息系统的方式,形成证据转化信息平台,并于2020年1月正式全面应用,比较使用前(2019 年)、使用后(2020 年—2023 年)住院儿童CVADs并发症和非计划性拔管等结局指标情况.结果:应用平台后,住院儿童CVADs相关的并发症和非计划拔管率较应用前均有所下降(P<0.001).结论:平台的构建与应用,实现了从置管、维护到拔除的全流程信息化管理,提高了护士对循证证据的依从性,实现了儿童健康教育同质化,降低了导管相关并发症;同时平台的应用能及时、客观地提供数据并预警,使各部门实现信息联通共享,提高了导管安全管理水平和效率,更好地保障患者的医疗安全.
Construction and application of the CVAD safety management information platform for children
Objective:To construct an evidence-based Central Venous Access Devices(CVAD)safety management information platform(hereinafter referred to as the platform)and evaluate its application effects to enhance the compliance of nurses in evidence-based practice,promote the clinical transformation of evidence,reduce catheter-related complications and improve catheter safety.Methods:Literatures on the placement,maintenance and removal of CVADs for children were searched to extract specific measures which were then assessed and adopted according to feasibility,appropriateness,meaningfulness and effectiveness(FAME).Later the way of embedding in the information system was formulated to form an evidence transformation information platform,which was officially and thoroughly applied in January 2020.Indicators such as CVAD-related complications and unplanned extubation in hospitalized children were compared before(2019)and after(2020-2023)the application of the platform.Results:After the implementation of the platform,the rate of CVAD-related complications and unplanned extubation in hospitalized children decreased significantly(P<0.001).Conclusion:The construction and application of the platform can ensure the information management of the whole process from catheter placement,maintenance to extubation,improve nurses'compliance to evidences in practice to boost the homogenization of patient health education and reduce catheter-related complications.Meanwhile,the platform can provide timely and objective data and early warning,so that information communication among all departments in a hospital can be realized to improve catheter safety management for patients.

Central Venous Access Deviceschild catheter safetyinformation platformevidence-based practicesmart hospital

孙黎、贺芳、沙晓妍、黄文娟、周军、刘美仪、梁茜、顾莺、林艳

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广州医科大学附属妇女儿童医疗中心NICU,510623 广州市

广州医科大学附属妇女儿童医疗中心护理部,510623 广州市

复旦大学附属儿科医院护理部

中心静脉血管通路装置 儿童导管安全 信息平台 循证实践 智慧医院

2024年度广州市卫生健康科技一般引导项目

20241A011029

2024

中国护理管理
卫生部医院管理研究所

中国护理管理

CSTPCD北大核心
影响因子:2.545
ISSN:1672-1756
年,卷(期):2024.24(8)