Current status of nursing practice for prevention and control of venous catheter-related bloodstream infections in ICU of tertiary grade A hospitals
三级甲等医院ICU中心静脉导管相关血流感染防控护理实践现况

摘要

目的 了解三级甲等医院重症监护室（ICU）中心静脉导管相关血流感染（CLABSI）防控护理的临床实施现状，分析影响感染防控效果的关键因素，为优化护理流程、降低CLABSI发生率提供实践依据。方法 选取某三级甲等医院ICU 2025年1-12月收治的60例留置中心静脉导管患者作为研究对象，回顾性分析其临床资料，采用统一制定的CLABSI防控护理方案开展干预，包括置管前评估、置管中无菌操作、置管后维护、感染监测及拔管管理等全流程护理措施，统计患者一般资料、导管留置时间、CLABSI发生情况及护理措施执行合格率。结果 60例患者中发生CLABSI 2例，感染发生率3.33%，导管总留置日数896日，感染密度2.23‰；核心护理措施执行合格率依次为96.67%、95.00%、93.33%、91.67%、90.00%；单因素分析显示，导管留置时间大于7天、使用多腔导管及未实施集束化护理为CLABSI发生的危险因素（P＜0.05）。结论 该院ICU中心静脉导管相关血流感染防控护理整体落实较好，CLABSI发生率处于较低水平，但导管留置时间过长、部分护理操作执行不规范仍为主要风险点，需进一步强化集束化护理落实、缩短导管留置时间、加强护理过程质控，持续提升ICU导管相关感染防控水平。

Abstract

Objective To understand the clinical implementation status of prevention and control nursing for central venous catheter-related bloodstream infections (CLABSI) in the intensive care unit (ICU) of a tertiary hospital, analyze the key factors affecting the effectiveness of infection prevention and control, and provide practical basis for optimizing nursing processes and reducing the incidence of CLABSI.
Methods Sixty patients with indwelling central venous catheters admitted to the ICU of a tertiary hospital from January to December 2025 were selected as the research subjects. Their clinical data were retrospectively analyzed, and a unified CLABSI prevention and control nursing plan was adopted for intervention, including pre catheterization evaluation, aseptic operation during catheterization, post catheterization maintenance, infection monitoring, and extubation management. The general information of patients, catheter retention time, occurrence of CLABSI, and the compliance rate of nursing measures were statistically analyzed.
Results Among the 60 patients, 2 cases of CLABSI occurred, with an infection rate of 3.33%. The total number of catheter retention days was 896 days, and the infection density was 2.23 ‰; The qualified rates of implementing core nursing measures are 96.67%, 95.00%, 93.33%, 91.67%, and 90.00%, respectively; Univariate analysis showed that catheter retention time greater than 7 days, use of multi lumen catheters, and failure to implement bundled care were risk factors for the occurrence of CLABSI (P<0.05).
Conclusion   The overall implementation of prevention and control nursing for venous catheter-related bloodstream infections in the ICU of this hospital is good, and the incidence of CLABSI is at a low level. However, the long indwelling time of the catheter and the non-standard execution of some nursing operations are still the main risk points. It is necessary to further strengthen the implementation of bundled nursing, shorten the indwelling time of the catheter, strengthen the quality control of the nursing process, and continuously improve the level of prevention and control of catheter-related infections in the ICU.