BJ Union Hospital: Set up PICC and put the tube

BJ Union Hospital: Set up PICC and put the tube to maintain " The gold standard "
Staff reporter cub reporter Sun Meng sweet Beibei

Puncture a conduit from patient's elbow to put into the blood vessel, reach the superior vena cava in the thorax. During one year, chemotherapy medicine that the patient needs, nutritive medicine,etc. are input from this passway. This intravenous to put into the intravenous conduit (PICC) of in the center by periphery Put into technology. Patient that it is damaged that severe to some blood vessels, serious edema, severe cover decreased, the conduit is theirs " The lifeline " .

As best one of the routes of infusing for a long time generally acknowledged at present, PICC technology can avoid the blood vessel damage that bring because of infusing or infusing high density, strong stimulating medicine for a long time, also can lighten the repeated intravenous agony that punctures. However, this technology is extremely apt to initiate thrombus, phlebitis, conduit stopping up and such complications as blood influenza is caught.

How to guarantee a patient puts and is in charge of the security? Wu XinJuan, head of the nursing department of BJ Union Hospital, says, PICC whole management mode which this institute sets up, succeed in controlling the incidence of the overall complication in 4.8%, is far lower than the similar data both at home and abroad. A few days ago, this institute tried to find out this set of management systems set up through practice of more than ten years, obtain the scientific award second prize of the first Chinese nurses association.

The accident occurs frequently in the area: Can " pitch the upper needle " It is successful to put the tube

In a physical examination of March of this year, Mr. Zhang is found and suffered from rectal cancer, one tertiary hospital has accepted in Beijing PICC conduit is put into. Have never expected the tube has been buried in, but the state of stopping up etc. the conduit takes place. At night of one day in May, because ooze the blood, Mr. Zhang has to go to the hospital to wash the conduit by car twice.

"It costs 1500 yuan to put such a tube, all at one's own expense. If can not do well and must pull out and manage, except incuring loss in economy, will also increase the extra agony for patients. Trouble paid to maintain increase more burdens for patients too. " Mr. Zhang says.

It is introduced, because there is no unified standardard management of operation, in relevant literature and report at home and abroad, the relevant complication incidence of PICC conduit like Mr. Zhang is up to more than 10%.

ChangSun WenYan, nurse of nutriology dept., tells reporters outside the intestines in BJ Union Hospital intestines, PICC conduit is put into succeeding in, the ones that were considered are not merely " imbedding " ,And will let the patient have no complication to happen during taking the tube. For this reason, BJ Union Hospital has made 12 kinds PICC operation regulations, to putting the tube, put in the tube, put the maintenance after the tube, prevention and treatment of complication, the ~s links of preventing from etc. of the relevance infection of the conduit implement " defeat in detail " . At present, system of this quality control is basically ripe. Statistics reveal, in the past 3 years, this institute PICC relevant phlebitis incidence is 0.56%, the malposition incidence of the conduit is 3.1%, it is 1.5% that the conduit stops up the incidence; But the similar data both at home and abroad are 5%~10%, 5%~8% and more than 10% respectively.

Intensify management: Could be experienced to seem more

"Put to conduit into and follow-up maintain implement, intensify, manage, lower the intersection of complication and another magic weapon of incidence. " Wu XinJuan says.

Wu XinJuan introduced, before 2006, PICC of BJ Union Hospital was put and in charge of and safeguarded and dispersed in each inpatient area, operated by every ward nurse. The in charge of and safeguarding competence to be different putting of ward nurse, it is not enough for treatment in the complicated problem to have experiences, it is apt to bring the potential safety hazard. 2006, BJ Union Hospital has established PICC conduit to maintain the clinic, there are 3 training nurses that are responsible for putting tube and the out patient's conduit to maintain of the impatient specially in the department, forming, critical serious disease and happen suddenly on operate for standardization treatment of the state lay a solid foundation.

It is reported, BJ Union Hospital is very tight when checking on the entry of PICC nurse, the persons who are selected must have academic credentials above three years education and working experience of more than 5 years, still need to train and can obtain qualification through 3 stages. The validity of this qualification is only one year, authorize again every year. This institute will also organize PICC training nurse to train the whole institute's nurse regularly every year, the content includes aseptic idea and operating aseptically, conduit maintaining, complication are prevented and observed etc..

Lower the complication incidence, the regular maintenance of the conduit is very important. Maintain and include giving and puncturing some and sterilizing, washing conduit,etc.. This institute should carry on the conduit once and maintain to each patient with the conduit every week. Wu XinJuan introduces, in BJ Union Hospital carries on the patient that PICC puts the tube, more than 70% are all tumour patients, the great majority in them need to treat the intermittence one and take the tube to go home. Teach patients daily observation and attentive matters of conduit, it is the important links of controlling complication to take place.

BJ Union Hospital takes the tube to release the brochure of a health education before going home each patient, and enclose department's business card and telephone, sign " the conduit is maintained and carried out the application " ,Importance and risk that the conduit will be maintained will be told the patient, the question of letting them understand the conduit appear easily, know that observes the main point. "We still hold the free training class for patient relatives every year, advise the patient to come to the hospital to do once and safeguard every week. " Sun WenYan says, since safeguarding clinic to establish, in becoming a patient that safeguard on time, have not stopped up no conduit so far.



BJ Union Hospital: Set up PICC and put the tube to maintain " The gold standard "