Influencing factors of maintenance and promotion of peripherally inserted central catheter in community under the medical alliance model
10.3760/cma.j.cn115682-20210506-01951
- VernacularTitle:医共体模式下社区经外周静脉穿刺置入中心静脉导管维护推广的影响因素分析
- Author:
Guifen LI
1
;
Lanlan MA
;
Jing SONG
;
Jing JIN
Author Information
1. 浙江中医药大学滨江学院附属富阳第一医院院办，杭州 311400
- Keywords:
Community health center;
Peripherally inserted central catheter;
Catheter maintenance;
Medical alliance model;
Influencing factors
- From:
Chinese Journal of Modern Nursing
2022;28(5):643-650
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To understand the influencing factors of the maintenance and promotion of peripherally inserted central catheter (PICC) in the community under the medical alliance model, and provide a basis for realizing the full coverage of PICC maintenance clinics at each site in the medical community.Methods:Using the cluster sampling method, a total of 79 patients with PICC in 10 communities participating in the medical alliance model in Hangzhou and 67 community nurses participating in PICC maintenance were selected as the research objects from January to February 2021. The patients and nurses were surveyed by using the patient questionnaire and the nurse questionnaire, respectively. Univariate analysis and Logistic regression were used to analyze the influencing factors of community PICC maintenance and promotion under the medical alliance model, and the theoretical knowledge and operation of PICC maintenance for community nurses were assessed. According to the 8-month promotion of communities, 3 communities with more than or equal to 40 PICC maintenance patients were selected as the promotion advantage communities, and the remaining 7 communities were selected as the promotion disadvantage communities. And the influencing factors of promotion results among the superior and inferior communities were compared and analyzed.Results:In the univariate analysis of the patient survey, payment method, mobility, transportation mode, transportation cost, receiving follow-up, satisfaction with community consultation process and maintenance technology were the influencing factors of community PICC maintenance and promotion under the medical alliance model ( P<0.05) . In the univariate analysis of the nurse survey, publicity channel, performance distribution, shift arrangement, family doctor team and door-to-door maintenance were the influencing factors of community PICC maintenance and promotion under the medical alliance model ( P<0.05) . There were statistically significant differences in knowledge and operation skills of PICC complications among superior and inferior community nurses ( P<0.05) . Logistic regression analysis showed that patients' behavior ability and whether they were followed up were the influencing factors of community PICC maintenance and promotion ( P<0.01) . Conclusions:Based on the medical community model, the homogenization training and management of PICC maintenance should be carried out in the community, the family doctor team should be used to carry out regular follow-up for patients with catheterization, the maintenance process of PICC in the community should be simplified, the publicity of various ways should be strengthened, the ability of community nurses to deal with PICC complications should be continuously improved and the performance allocation scheme should be adjusted to improve the initiative of nurses. And strengthening the two-way referral linkage mechanism between the general hospital and the community, providing consultation support to the community and solving the reimbursement channels for diseases specified in the maintenance of community PICC can promote the promotion and maintenance of PICC in community.
