| Objectives:1.To learn about the occlusion status of Femoral Inserted Central Catheter(FICC)occlusion(FICC was PICC inserted through superficial femoral vein in this study),and identify its influencing factors,so as to provide reference for formulating FICC occlusion intervention program.2.In order to provide a basis for related nursing measures and reduce the incidence of FICC occlusion in clinical practice,construct a scientific,efficient and feasible intervention program for FICC occlusion,.Methods:1.The data of patients who underwent FICC catheterization,maintenance and removal from January2015 to April 2022 in a large comprehensive tertiary hospital in Zhejiang Province were retrospectively collected through the modern electronic database.To determine the related influencing factors of FICC occlusion,SPSS 26.0 software was used to analyze the data by univariate and binary Logistic regression.2.Based on the results of the preliminary analysis of influencing factors of this study and literature review,the FICC occlusion intervention program was initially constructed in the research group.Delphi method was used to score the importance and operability of the constructed program,and experts were requested to propose professional opinions on item modification,so as to form the final version of FICC occlusion intervention program.Results:1.A total of 241 patients who met the inclusion and exclusion criteria for FICC catheterization were collected in this study,of which 58 cases(24.07%)had FICC tube occlusion.Logistic regression analysis showed that the independent risk factors for FICC occlusion were accompanying catheter prolapse(0R=2.239,95%CI =1.111-4.514,P = 0.024),the first time catheterization(0R =5.033,95%CI =1.085-23.343,P = 0.024),and the first time catheterization(0R =5.033,95%CI =1.085-23.343,P = 0.039),patients who walked regularly(0R = 3.588,95%CI =1.173-10.974,P = 0.025)and catheter material resistant to high pressure(0R =2.294,95%CI =1.039-5.067,P = 0.040).2.In this study,a total of 17 experts were invited to inquire about FICC occlusion intervention.After two rounds of Delphi method,the expert opinions tended to be consistent,and the complete intervention program was formed.The effective recovery rates of the two rounds of Delphi method,questionnaire were both 100%.In the first round of expert consultation,the coefficient of variation was in the range of0.00-0.39,the expert authority coefficient was 0.889,the coordination coefficients of importance and operability scores were 0.14 and 0.17,the value of the significance test were all P < 0.001.In the second round of expert consultation,The coefficient of variation was in the range of 0.00-0.26,the expert authority coefficient was 0.877,and the coordination coefficients of importance and operability scores were 0.17 and0.21,the values of significance test results were all P < 0.001.Conclusions:1.The incidence of FICC occlusion is high.In clinical practice,we should pay more attention to the independent risk factors of catheter occlusion,including patients with first-time catheterization,patients who often walk,patients with catheter prolapse complications,and catheters made of high-pressure resistant.In order to reduce the incidence of FICC occlusion,targeted intervention measures and health education related to catheter maintenance based on this Should be carry out.2.The FICC occlusion intervention program was constructed in this study,including 4 first-level items,12 second-level items and 56 third-level items.The program summarized the operators,intervention programs before catheterization,during catheterization and after catheterization.The results of Delphi method are reliable,which has reference and guiding significance for the clinical practice of FICC occlusion. |
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