The Study Of Cluster Nursing To Prevent The Central Venous Catheter-related Bloodstream Infection Rates In ICU Patients

Object To investigate the effect of cluster care to prevent central venous catheter-related bloodstream infection in ICU patients. Methods This study performed prospective historically controlled clinical study.325 critically ill patients with central venous catheters receiving routine care from January to December 2013 were selected as the control group, meanwhile,469 critically ill patients with central venous catheters receiving cluster care during January to December 2014 were selected as the experimental group. The incidence of catheter-related bloodstream infection, catheter indwelling time, ICU hospitalization days, catheters usage rate, extubation temperature, white blood cell count, serum c-reactive protein and pathogenic bacteria distribution characteristics were compared between the two groups. Results The catheter-related bloodstream infection rate of control group was 6.604‰(26 cases in 3937 catheter days), those of experimental group was 1.843‰(10 cases in 5426 catheter days), the catheter-related bloodstream infection rate of experimental group significantly lower than control group, showed significant differences between the two groups(χ2=15.270,P=0.000). The catheter indwelling time and ICU hospitalization days of control group respectively was(15.94±6.07) d and(18.61±8.71) d, those of experimental group respectively was(9.39±4.42) d and(12.93±7.43) d, the catheter indwelling time and ICU hospitalization days of experimental group significantly shorter than control group, showed significant differences between the two groups(t=6.061、4.332,P=0.014、0.037). The catheters usage rate of experimental group significantly lower than control group, showed significant differences between the two groups(P<0.05). In the control group, the temperature ≥38℃ for 19.38%(63/325), the temperature<38℃ for 80.62%(262/325). In experimental group, the temperature ≥38℃ for 3.43%(16/469), the temperature<38℃ for 96.59%(453/469), showed significant differences between the two groups(χ2=57.151,P=0.000). In the control group, the WBC>10×109/L for 14.77%(48/325), the WBC<10×109/L for 85.23%(277/325). In experimental group, the WBC>10×109/L for 2.77%(13/469), the WBC<10×109/L for 97.23%(456/469), showed significant differences between the two groups(χ2=38.959,P=0.000). Two groups of patients with gram-positive bacteria and gram-negative bacteria flora distribution was no statistical significance(P >0.05). Conclusion Bundles of Care can effectively prevent the central venous catheter-related bloodstream infections in the ICU, and further optimize care and measures to achieve the goal of zero rates in catheter-related bloodstream infections will be come true.