| ObjectiveTo construct a bundled nursing strategy to prevent complications after midline catheter placement in patients with cerebrovascular disease who received interventional therapy,and explore effective preventive measures for complications in clinical practice,in order to reduce its incidence.MethodsA total of 100 patients with cerebrovascular disease who met the inclusion and exclusion criteria in our department were selected from March to September 2018.Different diseases were randomly divided into control group and intervention group with the method of sampling Fifty cases in Department 3 were selected as control group,while 50 cases in Department 1 as intervention group.The control group received routine nursing,and the intervention group implemented bundle nursing on this basis,which mainly included nursing evaluation based on evidence-based pre-catheterization,standardized and improved puncture technology,homogeneous standardized catheter maintenance,and related education after catheterization.Data collection were applied before and 6 months after intervention.The related complications,comfort and pain after catheterization were compared between the two groups.EpiData 3.1 was used to input data,and using statistical software SPSS21.0,statistical description of data and statistical software SPSS21.0 was used to describe and analyze the data.Data analysis was performed by x 2 test and t test,inspection level ?=0.05.Results1.Comparison of the general condition of the two groups of patientsIn this study,the bundle nursing program was implemented for 6 months and the samples of intervention group and control group did not fall off.There was no significant difference between the two groups in general data such as age,educational background,family monthly income,payment method,infusion treatment history,basic condition and previous high-risk medical history(P>0.05).2.Comparison of Midline Catheterization Complications Between Two Groups of PatientsThe incidence of catheter blockage,ectopic catheter,phlebitis,venous thrombus,catheter related bloodstream infection in the intervention group was 4%,2%,4%,2%and 0%,while in the control group was 6%,6%v12%,4%and 0%,respectively.The overall complications incidence was 12%in the intervention group and 28%in the control group.The complication rate in intervention group was significantly lower than control group(?2=4.000,P<0.05).3.Comparison of hospitalization time and hospitalization cost between two groups of patientsThe hospitalization time in intervention group and control group were 17.00±2.10 days and 23.00±3.20 days(P<0.05).the hospitalization costs in intervention group and control group were 68.30±56.70thousand yuan and 73.10±49.60thousand yuan(P<0.05).4.Comparison of comfort scores between two groups of patientsBefore intervention:There is no statistically significant difference between the intervention group and the control group in the four dimensions of physiology,psychology,spirit,social culture and environment(P>0.05);After intervention(24 hours after catheter application):The two groups were compared from four dimensions of physiology,psychology,spirit,social culture and environment.There was no significant difference in spirit dimension(P>0.05),and there was significant difference in other dimensions(P<0.05);After intervention(7 days after catheter application):The two groups were compared from four dimensions of physiology,psychology,spirit,social culture and environment.There was no significant difference in physiological dimension(P>0.05),and there was significant difference in other dimensions(P<0.05).5.Comparison of pain level between two groups of patients after interventionBefore intervention:there was no statistically significant difference between the two groups from three dimensions of pain level including current pain level,24-hour maximum pain,and average pain level in the past 24 hours(P>0.05).There was no statistically significant difference between the two groups from the five dimensions of pain's influence on activity,daily activity,emotional walking ability and other people's relationship,sleep(P>0.05).After the intervention(24 hours after catheter application):the difference between the two groups from the three dimensions of the current degree of pain,the most severe pain in 24 hours,and the average level of pain in the past 24 hours was statistically significant(P<0.05).There was no statistically significant difference between the four dimensions of daily activities,emotions,walking ability,and relationship with others of the impact of pain on activities in the group(P>0.05),and there was statistically significant difference between the dimensions of sleep and other rehabilitation activities(P<0.05).After intervention(7 days after catheter application):the difference between the two groups was statistically significant from three dimensions of pain level:current pain level,the most intense pain in 24 hours,and the average pain level in the past 24 hours(P<0.05).The difference between the two groups was statistically significant from the five dimensions of the influence of pain on activity,the emotional walking ability and the relationship between others,sleep and other rehabilitation activities(P<0.05),while the difference in the daily activity dimension was not statistically significant(P>0.05).ConclusionsThis study developed bundle nursing measures based on the use of standardized tools for preplacement assessment,improved tube placement,optimize the maintenance mode of midline catheter,and improved functional exercise after catheterization.Bundle nursing is a safe and effective nursing intervention.At the same time,this strategy can reduce the incidence of total complications of midline catheter in interventional treatment of cerebrovascular diseases,improve patient comfort,reduce midline catheter-related pain,shorten hospitalization time and reduce hospitalization expenses. |
PDF Full Text Request