Evidence-based practice in the prevention and management of peripherally inserted central catheter-associated skin injury in patients with tumors of hematologic system

Objective To observe the effect of the evidence-based practice in the prevention and management of peripherally inserted central catheter(PICC) catheter-associated skin injury (CASI) in patients with tumors of hematologic system.

Methods According to the application model of Joanna Bfiggs Institute(JBI) clinical evidence practice, the evidence of CASI prevention in patients with tumors of hematologic system undergoing PICC catheterization was summarized in the early stage, the corresponding clinical review indexes were formulated. The detailed reviews and analysis of obstacle factors were conducted, and they were applied in clinical practice. A total of 57 patients with tumors of hematologic system undergoing PICC catheterization before evidence application were enrolled as evidence pre-application group between May 2020 and May 2021, while 63 patients after evidence application were enrolled as evidence post-application group between June 2021 and June 2022. The occurrence of skin pruritus, pain and CASI after dressing removal and CASI were compared between the two groups. The cognition of CASI prevention knowledge before and after evidence-based practice, and the implementation of review indexes after evidence application were compared.

Results After the application of evidence, the proportion of patients with skin pruritus and pain after dressing removal and the incidence of CASI were lower than those before the application of evidence (P < 0.05). After the application of evidence, the reaching the standard rate of index 1 performance was 93.33%, and the reaching the standard rates of indexes performance 2 to 7 were increased to 81.67%, 83.33%, 86.67%, 88.33%, 78.33% and 91.67%, respectively, and reaching the standard rates of indexes 8 to 10 were increased to 100.00%.

Conclusion Evidence-based practice in the prevention and management of CASI can reduce the incidence of CASI in patients with tumors of hematologic system, and improve nurses′ cognition rate to CASI prevention knowledge and implementation compliance.