摘要
目的:对重症监护室病人发生中心静脉导管相关血流感染影响因素的相关研究进行范围综述。方法:按照Arksey和O'Malley的范围综述报告框架,根据循证资源“5S”金字塔模型,自上而下依次检索BMJ最佳临床实践、国际指南协作网(GIN)、美国国立指南文库(NGC)、英国国家临床优化研究所指南库(NICE)、苏格兰学院间指南网络(SIGN)、加拿大安大略注册护士协会(RNAO)、医脉通、澳大利亚乔安娜布里格斯研究所(JBI)循证卫生保健中心、PubMed、Web of Science、the Cochrane Library、CINAHL、Embase、中国知网(CNKI)、万方数据库、维普中文科技期刊数据库和中国生物医学文献数据库,文献类型包括临床实践指南、证据总结、最佳实践、实践推荐、系统评价及原始研究。检索时限为2019年1月1日—2024年9月30日。对中英文文献进行检索和筛选,对纳入文献进行汇总和分析。结果:共纳入22篇文献,来自22个国家,包括4篇指南、1篇证据总结、2篇专家共识、1篇实践推荐、3篇系统评价及11篇原始研究。文献分析提示重症监护室病人发生中心静脉导管相关血流感染的影响因素包括人口学特征相关因素;疾病、治疗及住院相关因素;置管因素;导管维护的无菌技术;导管维护时医护人员的操作行为等。结论:重症监护室病人中心静脉导管相关血流感染的影响因素具有复杂性、多样性,未来医疗机构可基于上述影响因素优化中心静脉导管相关血流感染防控的监测指标。在医护人员操作方面可控性较强,医院应对重症监护室医护人员加强监督、规范导管操作流程,提升操作者的技能水平及专业素养,以降低重症监护室病人中心静脉导管相关血流感染发生率。
Objective:To conduct a scoping review of studies regarding the influencing factors of central line⁃associated bloodstream infection in ICU patients.Methods:According to the scoping review framework developed by Arksey and O'M alley and follow ing the"5S"pyramid model of evidence⁃based resources,a top⁃down search was conducted across the following databases:BMJ Best Practice,the Guidelines International Network(GIN),the National Guideline Clearinghouse(NGC),the National Institute for Health and Care Excellence(NICE)guidelines repository,the Scottish Intercollegiate Guidelines Network(SIGN),the Registered Nurses'Association of Ontario(RNAO),Medlive,the Joanna Briggs Institute(JBI)Evidence⁃Based Healthcare Center,PubMed,Web of Science,the Cochrane Library,CINAHL,Embase,China National Knowledge Infrastructure(CNKI),Wanfang Database,VIP Chinese Science and Technology Journal Database,and the China Biology Medicine disc(CBM).The literature types included clinical practice guidelines,evidence summaries,best practice recommendations,practice recommendations,systematic reviews,and original studies.The search period was set from January 1,2019,to September 30,2024.Both Chinese and English literature were searched and screened,followed by data extraction and synthesis of the included studies.Results:A total of 22 studies from 22 countries were adopted,including 4 guidelines,1 practice recommendation,2 expert consensuses,1 evidence summary,3 systematic reviews and 11 original studies.Literature analysis indicates that the factors influencing the occurrence of central line⁃associated bloodstream infections in ICU patients include:demographic characteristics;disease⁃,treatment⁃,and hospitalization⁃related factors;catheter insertion factors;aseptic techniques during catheter maintenance;and the operational practices of healthcare staff during maintenance,etc.Conclusions:The influencing factors of central line⁃associated bloodstream infection in ICU patients were found to include 6 aspects,which are complex and diverse.In the future,medical institutions can optimize the monitoring indicators for central line⁃associated bloodstream infection based on the above influencing factors.Among these factors,the operational practices of healthcare staff are relatively more amenable to intervention.Hospitals should enhance supervision,standardize catheter operation procedures,and improve the skill level and professional competence of ICU medical personnel to reduce the incidence of central line⁃associated bloodstream infections in ICU patients.
作者
王喆
张玉侠
胡雁
李春雷
杨马裔
和晓凤
周天君
WANG Zhe;ZHANG Yuxia;HU Yan;LI Chunlei;YANG Mayi;HE Xiaofeng;ZHOU Tianjun(Zhongshan Hospital Affiliated to Fudan University,Shanghai 200032 China)
出处
《全科护理》
2026年第4期648-654,共7页
Chinese General Practice Nursing
基金
2022年复旦-复星护理科研基金立项项目,编号:FNF202201。
关键词
重症监护室
中心静脉导管相关血流感染
范围综述
intensive care unit,ICU
central line⁃associated bloodstream infection
scoping review
