Background: Central venous catheterization is an invasive procedure that may lead to central line-associated bloodstream infection, affecting the patient's prognosis and recovery. Thus, it is essential to master the right interventions for the prevention and control of central line-associated bloodstream infections. FOCUS-Plan-Do-Check-Act (PDCA) cycle management model, also known as Deming circle management model, is a programmed and scientific management method.
Objective: We attempted to clarify the impact of nursing intervention on preventing and controlling central line-associated bloodstream infection under the FOCUS- PDCA cycle management model, in order to effectively deplete central line-associated bloodstream infection in each intensive care unit, facilitate early recovery of patients.
Design: Our study retrospectively analyzed the clinical data of intensive care unit patients before and after implementation of nursing intervention under the FOCUS-PDCA cycle management model. This study was a retrospective study.
Setting: This study was performed in the Department of Infection Management, Taihe County People's Hospital.
Participants: A total of 214 intensive care unit patients with indwelling central venous catheters before implementation of nursing intervention under the FOCUS-PDCA cycle management model in our hospital in 2021 were selected as the control group. A total of 220 ICU patients with indwelling CVC after nursing intervention under the FOCUS-PDCA cycle management model in 2022 were included in the experimental group. All patients met the inclusion criteria of patients with CVC puncture catheterization for ≥ 2 days.
Interventions: The control group underwent conventional nursing, including (1) nurses observing aseptic technique; (2) nurses regularly inspected and replaced dressings; (3) nurses timely handled abnormal situations at the puncture site; (4) nurses provided relevant education and psychological counseling to patients and their families. The experimental group adopted nursing intervention under the FOCUS-PDCA cycle management model on the basis of that of the control group.
Primary outcome measures: (1) central venous catheterization puncture status (2) central venous catheterization application status (3) central line-associated bloodstream infection status, and (4) hospitalization status.
Results: The one-time success rate of puncture and success rate of puncture in the experimental group exhibited elevation relative to those in the control group (P < .05). The central venous catheterization application rate in the experimental group exhibited depletion relative to that in the control group (P < .05). The daily infection rate of CLABSI in the experimental group exhibited depletion relative to that in the control group, but without statistical significance (P > .05), indicating that nursing intervention under the FOCUS-PDCA cycle management model had no obvious inhibitory effect on the daily infection rate of CLABSI. The time of central line-associated bloodstream infection occurrence in the experimental group was later than that in the control group (P < .05). The hospitalization time and hospitalization expenses in the experimental group exhibited depletion relative to those in the control group (P < .05).
Conclusion: Nursing intervention under the FOCUS-PDCA cycle management model can effectively deplete central line-associated bloodstream infection in each intensive care unit, facilitate early recovery of patients, and shorten hospital stay, which is worthy of promotion. Our study provide a clinical nursing reference for the preventing and controlling central line-associated bloodstream infections in patients in each intensive care unit.