腹膜透析护士导管出口处护理实践调查分析

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Abstract Objective To understand the training status of catheter exit-site care (hereinafter referred to as "exit-site care") in peritoneal dialysis (PD) patients and the condition of exit-site care by PD nurses, so as to provide basis for the establishment of management standards and continuous improvement on quality of PD exit-site care.Methods The nursing version of Peritoneal Dialysis Catheter Exit-site Care Questionnaire was designed by researchers.From April to May 2018, 26 PD nurses in 10 hospitals with PD outpatient clinics in a coastal area of Guangdong Province were investigated through Questionnaire Star and WeChat APP.Results The average incidence of PD catheter-related infections in 10 hospitals with PD clinics in the area was about 0.15 times per year.Five of the ten hospitals had full-time and part-time nurses, and the other five hospitals had only part-time nurses (concurrently with ward nursing job).Among the 26 PD nurses, 9 cases (34.62%) were full-time PD nurses, the ratio of full-time nurses to patients was approximately 1∶95.67, and 17 cases (65.38%) were part-time PD nurses, the ratio of part-time nurses to patients was approximately 1∶37.76.The average training time of each patient was (15.39±5.06) hours by full-time nurses, and that by part-time nurses was (11.13±5.85) hours.All the PD nurses would retrain patients, and among them the retraining frequency of 13 PD nurses was fixed.A total of 92.31% of the PD nurses required post-shower exit-site care, 84.62% of the PD nurses required patients to change dressing once a day when the exit-site infections occurred, or even more frequently in other dressing changes.Only 2 PD nurses asked patients to routinely apply antibacterial ointment to prevent infections.Altogether 92.31% of the PD nurses could complete wound evaluation as suggested, 73.08% of the PD nurses used normal saline and iodine for disinfection and dressing change, and all the PD nurses could use dressings to cover the exit-site before maturity and during infections.Conclusion At present, half of the hospitals in this region that carry out PD treatment are in the initial development stage, and the ratio of nurses to patients among the hospitals varies greatly.The three aspects on training of patients, wound evaluation before dressing change and care points during dressing change are basically consistent with the International Society for Peritoneal Dialysis Guidelines.However, there is a difference in the application of antibacterial ointment from the guideline, which needs to be further studied.

Key words： Peritoneal dialysis nurses Catheter exit-site care Training Retraining Peritoneal dialysis catheter-related infections

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	YIN Chang
	LIAO Yu-mei
	ZHANG Li
	HUANG Hui-e

Cite this article:

YIN Chang,LIAO Yu-mei,ZHANG Li, et al. Investigation and analysis of catheter exit-site care by peritoneal dialysis nurses[J]. 中国当代医药, 2020, 27(12): 151-155.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2020/V27/I12/151

[3]	郑少莉，冯明亮，邓明，等.腹膜透析患者出口处感染和隧道炎的原因分析及护理对策[J].中外医疗，2010，29（9）：40-41.
[1]	陈香美.腹膜透析标准操作规程[G].北京：人民军医出版社，2012.
[2]	万玉红，刘红梅，杨玉红.预防性护理对腹膜透析患者导管感染率的影响[J].实用临床医药杂志，2017，21（10）：158-160.
[4]	Szeto CC，Li PK，Johnson DW，et al.ISPD catheter-related infection recommendation：2017 update[J].Perit Dial Int，2017，37（2）：141-154.
[5]	黄璐，田敏，程卓琼.规范化透析前培训对腹膜透析患者培训质量的影响[J].中国医学创新，2016，13（5）：102-105.
[6]	国际腹膜透析学会.腹膜透析患者及照顾者的培训教学大纲[S].2016.
[7]	Figueiredo AE，Bernardini J，Bowes E，et al.A syllabus for teaching peritoneal dialysis to patients an d caregivers[J].Perit Dial Int，2016，36（6）：592-605.
[8]	许莹.以国际指南为基础的腹膜透析患者培训[J].中国护理管理，2013，13（8）：13-15.
[9]	芦丽霞，赵慧萍.培训与再培训在居家腹膜透析中的作用[J].中国血液净化，2016，15（4）：199-201.
[10]	陆婉湘，邢小红.国内外腹膜透析培训现状及我国未来培训展望[J].护理实践与研究，2017，14（10）：15-17.
[11]	秦锦，孙庆华，苏春燕，等.北京地区腹膜透析护士外出口护理和培训实践现状调查[J].中国血液净化，2019，18（5）：345-348.
[12]	Parthasarathy R，Kashem T，NicFhogartaigh C，et al.Clinical value of screening peritoneal dialysis patients for bacterial colonization or contamination[J].Perit Dial Int，2019，39（2）：126-133.
[13]	Mushahar L，Mei LW，Yusuf WS，et al.Exit-site dressing and infection in peritonea l dialysis：a randomized controlled pilot trial[J].Perit Dial Int，2016，36（2）：135-139.
[14]	Elphick EH，Teece L，Chess JA，et al.Biocompatible solutions and long-term changes in peritoneal solute transport[J].Clin J Am Soc Nephrol，2018，13（10）：1526-1533.
[15]	林叶，陈文，庄乙君，等.改良腹膜透析置管术对导管相关并发症的影响[J].国际泌尿系统杂志，2017，37（5）：761-764.
[16]	Htay H，Cho Y，Pascoe EM，et al.Center effects and peritoneal dialysis peritonitis outcomes：analysis of a national registry[J].Am J Kidney Dis，2018，71（6）：814-821.