床边即时超声辅助疑难内瘘穿刺在18家医院的操作现状调查
Investigation on the operational status of point-of-care ultrasound assisted difficult arteriovenous fistu-la puncture in 18 hospitals
张洁婷 1李敬辉 1赵代鑫 1吴一帆 1梁玉婷 1李茵 1魏爽1
作者信息
- 1. 510006 广州,广东省中医院大学城医院血液透析中心
- 折叠
摘要
目的 调查床边即时超声(point-of-care ultrasound,POCUS)辅助疑难内瘘穿刺在18家医院的护理操作现状,为相关质量管理和专科培训提供科学依据.方法 对18家医院的POCUS辅助疑难内瘘穿刺操作视频进行横断面调查,制定操作的评分细则作为评分依据,根据操作中的关键点提取重点环节,对评分结果进行统计分析.结果 18例操作视频平均得分(79.25±10.91)分.共提取出6个重点环节,评分为较差的占比分别为:评估与安全核查55.56%、护患沟通50.00%、内瘘常规评估44.44%、感染控制38.89%、超声评估11.11%、超声引导穿刺0.视频时长与操作得分呈正相关(r=0.717,P=0.001).结论 本研究制定的"POCUS辅助疑难内瘘穿刺评分标准"有助于进一步规范此项操作,值得推广.
Abstract
Objective To investigate the nursing operation status of point-of-care ultrasound(POCUS)assisted difficult arteriovenous fistula(AVF)puncture in 18 hospitals in order to provide a scientific basis for quality management and specialized training of the clinical nursing operations.Methods This was a cross-sectional study.The videos of POCUS assisted difficult AVF puncture operation from the 18 hospitals were ex-amined.A scoring rule for the operation was developed as the scoring basis.Six key steps of the manipulation were extracted for the scoring,including routine evaluation and safety verification,nurse-patient communica-tion,infection control,AVF routine evaluation,ultrasound evaluation,and ultrasound guided puncture.The scores were then statistically analyzed.Results The average score of the manipulation on video from the 18 cases was 79.25±10.91.For the six key steps of the manipulation,ratios of the steps with low scores were eval-uation and safety verification 55.56%,nurse-patient communication 50.00%,AVF routine evaluation 44.44%,infection control 38.89%,ultrasound evaluation 11.11%,and ultrasound guided puncture 0% .The video dura-tion and the operation score were positively correlated(r=0.717,P=0.001).Conclusion The scoring stan-dard for POCUS assistant difficult fistula puncture developed in this study is helpful to standardize this proce-dure and is worth promoting.
关键词
血液透析/床边即时超声/动静脉内瘘Key words
Hemodialysis/Point-of-care ultrasound/Arteriovenous fistula引用本文复制引用
基金项目
广东省中医药管理局基金(20232042)
出版年
2024
NETL
NSTL
万方数据