Establishment and implementation of a nurse-led interdisciplinary management strategy for central line maintenance: A single-center experience

IF 2.9 3区 医学 Q1 NURSING International Journal of Nursing Sciences Pub Date : 2023-07-01 DOI:10.1016/j.ijnss.2023.06.014
Yuxin Yin , Changhua Tang , Lijie Zhang , Di Wu , Qing Sun
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Abstract

Objectives

This study aimed to establish and implement an interdisciplinary management strategy led by senior nurses via a vascular access specialist team (VAST) at a teaching hospital.

Methods

In 2021, the hospital established and implemented a nurse-led VAST management strategy to improve the quality of clinical central line maintenance. The VAST comprised senior nurses specialized in intravenous therapy, ultrasound/radiology technologists, medical doctors with central venous catheterization certificates, central line maintenance nurses, and administrative coordinators. The management strategy mainly included systemic on-the-job training for VAST members, the establishment of an interdisciplinary central line emergency “green channel,” the formation of a VAST-based, nurse-led standardized clinical rounding system, and the standardization of central line self-care instructions for patients. During the pre- (July 2020 to April 2021) and post- (May 2021 to May 2022) of the implementation the interdisciplinary management strategy, overall patients’ self-care ability, the success rate of catheterization at first time, central line management compliance rate, and patients’ satisfaction with catheter maintenance were investigated and compared.

Results

The results showed the score self-care ability was increased from 74.75 ± 18.4 (pre-VAST) to 99.10 ± 23.65 (post- VAST); the success rate for catheterization at first time was improved to 100% (225/225), compared to 92.9% (209/225) at pre-VAST; the central line management compliance rate was also increased to 99.6% (224/225) at post-VAST from 93.3% (210/225) at pre-VAST. A patient satisfaction survey on catheter maintenance showed improvements in all five indicators were compared to the pre- VAST (P < 0.05).

Conclusions

The nurse-led VAST interdisciplinary strategy can effectively improve the quality of clinical central line management and should be used to reinforce clinical catheterization and maintenance of central lines.

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建立和实施以护士为主导的中心静脉维护跨学科管理策略:单中心经验
目的本研究旨在通过教学医院的血管通路专家团队(VAST),建立并实施由高级护士领导的跨学科管理策略。方法2021年,医院制定并实施护士主导的VAST管理策略,以提高临床中心线维护质量。VAST包括专门从事静脉治疗的高级护士、超声/放射学技术人员、持有中心静脉导管插入术证书的医生、中心线路维护护士和行政协调员。管理策略主要包括对VAST成员进行系统的在职培训,建立跨学科的中心线应急“绿色通道”,形成基于VAST的、护士主导的标准化临床查房系统,以及标准化患者的中心线自我护理指导。在跨学科管理策略实施前(2020年7月至2021年4月)和实施后(2021年5月至2022年5月),对患者的整体自我护理能力、首次导管插入术成功率、中心线管理依从率和患者对导管维护的满意度进行了调查和比较。结果自我护理能力评分由VAST前的74.75±18.4分提高到VAST后的99.10±23.65分;首次导管插入术的成功率从VAST前的92.9%(209/225)提高到100%(225/225);中心线路管理符合率也从VAST前的93.3%(210/225)增加到VAST后的99.6%(224/225)。一项患者对导管维护的满意度调查显示,与VAST前相比,所有五项指标都有所改善(P<;0.05)。结论护士主导的VAST跨学科策略可以有效提高临床中心线管理的质量,应用于加强临床导管插入术和中心线维护。
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来源期刊
CiteScore
6.10
自引率
2.60%
发文量
408
审稿时长
25 days
期刊介绍: This journal aims to promote excellence in nursing and health care through the dissemination of the latest, evidence-based, peer-reviewed clinical information and original research, providing an international platform for exchanging knowledge, research findings and nursing practice experience. This journal covers a wide range of nursing topics such as advanced nursing practice, bio-psychosocial issues related to health, cultural perspectives, lifestyle change as a component of health promotion, chronic disease, including end-of-life care, family care giving. IJNSS publishes four issues per year in Jan/Apr/Jul/Oct. IJNSS intended readership includes practicing nurses in all spheres and at all levels who are committed to advancing practice and professional development on the basis of new knowledge and evidence; managers and senior members of the nursing; nurse educators and nursing students etc. IJNSS seeks to enrich insight into clinical need and the implications for nursing intervention and models of service delivery. Contributions are welcomed from other health professions on issues that have a direct impact on nursing practice.
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