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护理学报 ›› 2022, Vol. 29 ›› Issue (22): 46-51.doi: 10.16460/j.issn1008-9969.2022.22.046

• 循证护理 • 上一篇    下一篇

成人中线导管堵塞预防的最佳证据总结

刘纬华a, 白文辉a, 杜晓宁b, 赵文利c, 申丽香d, 路俊英e, 朱荣文d, 郑美琼f, 张红梅a   

  1. 河南省人民医院 a.护理部; b.心脏重症监护病房; c.介入导管室; d.消化内科; e.老年医学科; f.血液内科,河南 郑州 450003
  • 收稿日期:2022-05-13 出版日期:2022-11-25 发布日期:2022-12-07
  • 通讯作者: 张红梅（1964-）,女,河南郑州人,本科学历,主任护师,护理部主任。E-mail：Z126hm@126.com
  • 作者简介:刘纬华（1987-）,女,河南郑州人,硕士,主管护师,护理部副主任。

Best Evidence Summary for Prevention of Midline Catheter Blockage in Adults

LIU Wei-huaa, BAI Wen-huia, DU Xiao-ningb, ZHAO Wen-lic, SHEN Li-xiangd, LU Jun-yinge, ZHU Rong-wend, ZHENG Mei-qiongf, ZHANG Hong-meia   

  1. a. Dept. of Nursing Administration; b. Dept. of Coronary Heart Disease Care Unit; c. Dept. of Interventional Catheter Room; d. Dept. of Gastroenterology; e. Dept. of Geriatric Medicine; f. Dept. of Hematology, Henan Provincial People’s Hospital, Zhengzhou 450003, China
  • Received:2022-05-13 Online:2022-11-25 Published:2022-12-07

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摘要： 目的 检索成人中线导管堵塞预防的相关证据,并对最佳证据进行总结,为临床护士实施中线导管护理提供参考。方法 计算机检索UpToDate、BMJ、JBI、Cochrane Library、NICE、GIN、SIGN、NGC、RNAO、INS、Embase、Web of Science、PubMed、CINAHL、SinoMed、医脉通、中国知网、万方数据库,根据纳入与排除标准对文献进行筛选。由2名研究员独立评价文献质量,提取和汇总证据。结果 共纳入文献11篇,包括5篇指南、4篇专家共识、2篇系统评价,从导管堵塞识别、风险评估、导管置入、导管及附件、尖端位置、导管固定、冲管和封管、患者教育、组织政策9个方面汇总48条最佳证据。结论 基于证据构建成人中线导管堵塞预防策略,可为护理人员规范中线导管的使用提供循证依据。在应用证据时需综合考虑证据级别、临床情境及患者意愿等,降低中线导管堵塞的发生风险。

关键词: 中线导管, 导管堵塞, 证据总结, 循证护理

Abstract: Objective To retrieve evidence of prevention of midline catheter blockage in adults, and summarize the best evidence, and to provide reference for clinical nurses to implement midline catheter nursing. Methods Computer search was carried out on Up ToDate, BMJ, JBI, Cochrane Library, NICE, GIN, SIGN, NGC, RNAO, INS, Embase, Web of Science, PubMed, CINAHL, SinoMed, Medical Pulse, CNKI and Wanfang Database. Two researchers evaluated the quality of the literature, extracted and summarized the evidence independently. Results Eleven pieces of literature were included, including 5 guidelines, 4 expert consensus and 2 systematic evaluations. Forty-eight pieces of best evidence were collected from 9 dimensions: catheter blockage identification, risk assessment, catheter placement, catheter and accessories, tip location, catheter fixation, flushing and sealing, patient education and organizational policy. Conclusion The prevention of midline catheter blockage in adults based on evidence can provide evidence-based reference for nursing staff to standardize the use of midline catheter. The risk of middle line catheter blockage could be reduced by considering the level of evidence, clinical situation and patient’s willingness when applying evidence.

Key words: midline catheter, catheter blockage, evidence summary, evidence-based nursing

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