降低癌症病人週邊置入中心靜脈導管合併症發生率改善方案

Reducing Complications of Peripherally Inserted Central Catheter (PICC) in Patients With Cancer

本專案旨在降低癌症病人週邊置入中心靜脈導管合併症發生率。經資料收集及現況分析，確立問題為無標準化的照護作業、護理人員對週邊置入中心靜脈導管專業知識及換藥技能缺乏相關教育訓練、醫師插置經驗不足、感染防護措施不正確、病人自我照護認知不足。改善對策包含制定PICC照護標準、推動PICC在職教育及實務訓練、錄製PICC插置及換藥技術影片、監測導管插置與換藥過程、製作衛教單張等改善措施後，週邊置入中心靜脈導管合併症發生率由38％降至4.1%。本專案發現經由導管插置及換藥過程的稽核、專業教育訓練、多媒體教材、衛教單張的應用，不但能增加護理人員及病人的認知與照護技能外，且能降低導管合併症的發生。

The purpose of this project is to reduce complications in cancer patients with PICC by implementing an educational program in a medical ward of a medical center in Taiwan. The educational program included a series of training and demonstration of the standard care of PICC with a video developed by experts. Staff who were new and had limited experience in PICC care were invited and it aimed to improve staff’s knowledge and skill, establish a standard care procedure for patients in hospital and at home, and lastly to reduce complications of PICC in patients with cancer. This project found out that PICC-related complications rate sharply decreased and the rate dropped from 38% to 4.1%. The educational program, the video tape and establishment of the standards were approaches that effectively improved staff’s knowledge and thus, improved the quality of care and reduced complications of PICC.