Nursing summary and experience of 3 859 cases of venous catheterization in the department of oncology

Abstract

Objective To analyze the incidence and composition of complications of subclavian central venous catheter in the Department of Oncology, the characteristics of seasonal distribution and so on, and then provide the basis for prevention and control of complications. Methods To select the hospitalized patients from July 2000 to July 2013 in Yancheng Second People′s Hospital Eighth Department of Oncology, and according to the clinical technical standard, 3 859 cases are treated by subclavian puncture central venous catheterization, and cooperate with the whole course nursing. Analyzing the related factors of complications, and discussing its prevention and control measures. Results Catheterization success rate: there were 3 888 cases of puncture in total, and 3 859 catheter cases (99.25%) were succeeded. Infection rate and composition: a total of 89 cases (2.31%) were infected, including 65 cases (1.68%) of local infection, 5 cases (0.13%) of blood infection, 17 cases (0.44%) of blood infection suspicious, and 2 cases (0.05%) of local infection combined with blood infection. The local infection is the higheset (P<0.001). The infection rate of autumn is higher than spring, summer, and winter (P=0.022、<0.001、0.001, separately). Chlorhexidine gluconate disinfectant is superior to iodophor (P<0.001). Mechanical complications: Puncture injury in 119 cases (3.08%), 44 (1.14%) cases of ectopic catheter, catheter is not smooth in 53 cases (1.37%), fixation in 84 cases (2.18%), the blood flow back into the catheter in 20 cases (0.52%), the difficulty in decannulation and extubation hemorrhage in 1 cases (0.03%) respectively, 23 cases (0.60%) had allergy to dressing. No complications related to death. Conclusions The success rate of subclavian vein catheterization in the internal medicine oncology is high, the incidence of infection is low. Although there are many kinds of mechanical complications, the incidence of each complication is very low and not serious. Select the best disinfectant, improve the operation skills, and strictly control the risk factors associated with complications, combined with the strengthening of the whole process of care, complications can be controlled. Key words: Nursing services; Perioperative nursing; Complications; Central venous catheter