Construction And Evaluation Of Bundles Of Care For Patients With Breast Cancer After Peripherally Inserted Central Catheters

Objectives:This study was to establish bundles of care strategy for the prevention of complications after PICC cathetering in breast cancer patients under the concept of evidence-based medicine,and to investigate more effective complications preventative measures,in order to improve the coping capability in clinical medical workers in lowering the complication incident rate,and to provide theoretical evidence for further nursing services of relevant patients.Methods:Referring to relevant literatures,we put forward questions and synthesise evidence,construct of bundles of care for patients with breast cancer after peripherally inserted central catheters,Subjects from the breast surgery department at the affiliated hospital of Hebei University were recruited in this non-randomized concurrent controlled study by convenience sampling.68 breast cancer patients with PICC cathetering from the 1st ward were taken as experimental group,and 68 subjects with the same condition from the 2nd ward were set as control group.There was no difference in diagnosis of patients from two wards,and the patients shared the same medical team,therapeutic methods and nursing cares.The catheter operated by nursing staff who receive the peripherally inserted central catheters,and the routine maintenance performed by nursing who has no difference between the technique of nurse puncture and the maintenance of the catheterization.Conventional nursing measures were given to the control group,while the nursing team for experimental group was trained a series of clustering nursing measures,such as relevant knowledge,specified injection techniques,standardized catheter maintenance and post-cathetering health education.Then the incidence rates of complications from two groups were compared.Results:1.Before the intervention,there were no statistical significances between two groups of patients in general information as gender,age,height,weight,WBC,PLT,Staging of breast cancerand Operation mode.(P>0.05).2.There was no statistical significance in the cathetering sites(up/down the elbow)(right/left arm),catheter venous,catheter length,catheter method and in vitro catheter remaining length.(P<0.05)3.Complications were observed in 20 subjects in control group with an incident rate of 29.41% and 8 subjects in control group with an incident rate of 11.76%.Statistical significance was found2c test(c2 =6.476,P<0.05).4.The incident rates for phlebitis and venous thrombosis were significantly different in two groups(P<0.05).There were no significant differences in cathetering-related infection,catheter misplacement and errhysis between two groups(P>0.05).Conclusion:This study developed a nursing strategy to standardize health education technology,standardized puncture catheter maintenance,after catheter as the main body,clinical research shows that nursing strategy of scientific,reasonable and feasible,and is worthy of clinical promotion.The research results showed that the nursing strategy can reduce the PICC of breast cancer patients and the total complications of phlebitis and venous thrombosis related complications after the incidence of the guiding role of clinical nursing.Cluster nursing is still in the developing stage.Further research is needed to prevent the infection of catheter,bloodstream,catheter and blood flow after PICC catheterization in breast cancer patients.