成人外周静脉留置针导管失效预测模型的建立与验证

成人外周静脉留置针导管失效预测模型的建立与验证摘要

目的：建立成人外周静脉留置针导管失效预测模型，探究导管留置时间、患者疾病情况、插管部位、导管品种等因素对导管失效的影响。

方法：选取2018年1月至2020年1月在某三甲医院急诊科、内科和外科留置外周静脉留置针导管的患者201例为研究对象，采用朴素贝叶斯分类算法和多元逻辑回归分析建立外周静脉留置针导管失效预测模型，并进行验证。

结果：朴素贝叶斯分类算法和多元逻辑回归分析均表明，导管留置时间、患者疾病情况、插管部位、导管品种是导管失效的独立影响因素。将这些因素作为模型的输入变量，可以得到较高的预测准确率。

结论：成人外周静脉留置针导管失效预测模型的建立可以为护理人员提供可靠的导管留置时机及其制定护理计划的参考，减少导管失效所带来的相关不良后果，具有重要的临床意义和实用价值。

关键词：外周静脉留置针导管；预测模型；导管失效；疾病情况；导管品种

Abstract

Objective:Toestablishapredictivemodelforthefailureofperipheralvenouscatheterizationinadults,andtoexploretheeffectsoffactorssuchascatheterizationtime,patientdiseasecondition,insertionsiteandcathetertypeoncatheterfailure.

Methods:Weselected201patientswhoreceivedperipheralvenouscatheterizationintheemergencydepartment,internalmedicineandsurgerydepartmentsofatertiaryhospitalfromJanuary2018toJanuary2020asthestudyobjects.WeusedtheNaiveBayesclassificationalgorithmandmultiplelogisticregressionanalysistoestablishapredictivemodelforperipheralvenouscatheterizationfailureandvalidateit.

Results:BoththeNaiveBayesclassificationalgorithmandthemultiplelogisticregressionanalysisshowedthatcatheterizationtime,patientdiseasecondition,insertionsiteandcathetertypewereindependentinfluencingfactorsforcatheterfailure.Usingthesefactorsasinputvariablesforthemodelcouldyieldahighpredictionaccuracy.

Conclusion:Establishingapredictivemodelforperipheralvenouscatheterfailureinadultscanprovidereliablereferencefornursingstafftodeterminethecatheterplacementtimeandformulatenursingplans,reducetheadverseconsequencescausedbycatheterfailure,andhasimportantclinicalsignificanceandpracticalvalue.

Keywords:peripheralvenouscatheterization;predictivemodel;catheterfailure;diseasecondition;cathetertypPeripheralvenouscatheterizationisacommonprocedureinclinicalnursingpractice.However,catheterfailureremainsamajorproblem,whichcanleadtoadverseconsequences,suchaspain,infection,andevensepsis.Therefore,predictingtheriskofcatheterfailureisessentialfornursingstafftomaketimelyinterventions,reducetheincidenceofcomplications,andimprovepatientoutcomes.

Multiplefactorscaninfluencethesuccessofperipheralvenouscatheterization,includingpatientclinicalconditions,cathetertype,andinsertiontechnique.Byanalyzingthesefactors,apredictivemodelforcatheterfailurecanbeestablishedtoprovideguidancefornursingstaff.Thepredictivemodelcanincorporatevariousindicators,suchaspatientage,comorbidities,siteanddurationofcatheterization,cathetertypeandsize,andinsertiontechnique.

Moreover,machinelearningalgorithms,suchaslogisticregression,decisiontrees,andsupportvectormachines,canbeappliedtodevelopapredictivemodelwithhighaccuracy.Thesealgorithmscanlearnfromhistoricaldataandidentifypatternsinthedatatomakepredictionsaboutthelikelihoodofcatheterfailure.

Theestablishmentofapredictivemodelforperipheralvenouscatheterfailurehasimportantclinicalsignificanceandpracticalvalue.Itcanhelpnursingstafftodeterminetheoptimalplacementtimeforthecatheterandformulateeffectivenursingplans.Furthermore,itcanreducetheincidenceofcatheterfailure,preventcomplications,andimprovepatientoutcomes.

Inconclusion,developingapredictivemodelforperipheralvenouscatheterfailureinadultscanprovidenursingstaffwithareliablereferencetopredicttheriskofcatheterfailureandimplementtimelyinterventions.Itcanreducetheadverseconsequencescausedbycatheterfailureandimprovepatientoutcomes,makingitanessentialtoolinclinicalpracticeOnepotentialareaforfutureresearchistheexplorationofalternativemethodstoreduceperipheralvenouscatheterfailurerates.Onesuchmethodistheuseofultrasoundguidanceduringcatheterinsertion.Researchhasshownthattheuseofultrasoundguidanceduringperipheralvenouscatheterinsertionincreasesthesuccessrateanddecreasestheincidenceofcomplications,suchashematomaandphlebitis(Chauguleetal.,2016).Additionally,theuseofultrasoundguidancehasbeenshowntoincreasethelongevityofcatheteruse(Marshetal.,2016).Furtherresearchcouldfocusonimplementingultrasoundguidanceasastandardpracticeforperipheralvenouscatheterinsertioninclinicalsettings.

Anotherareaforfutureresearchisthepotentialimpactofnursingeducationandtrainingonperipheralvenouscatheterfailurerates.Nurse-ledinterventions,suchaseducationandtrainingsessions,havebeenshowntoreduceperipheralvenouscatheterfailureratesinvariousclinicalsettings(Alexandrouetal.,2015;Rickardetal.,2010).Theseinterventionscanincludetopicssuchaspropercatheterinsertiontechniques,identifyingsignsofcatheterfailure,andimplementingtimelyinterventionstopreventcomplications.Futureresearchcouldexploretheimpactofcomprehensivenursingeducationandtrainingprogramsonperipheralvenouscatheterfailureratesandpatientoutcomes.

Finally,thedevelopmentofastandardizedprotocolforperipheralvenouscatheterinsertionandmanagementcouldbeexplored.Astandardizedprotocolcouldhelpensurethatallnursingstaffarefollowingthesameproceduresandimplementingtimelyinterventionstopreventcatheterfailure.Additionally,astandardizedprotocolcouldincludeguidelinesforcatheterremoval,whichcanalsoplayaroleinpreventingcomplicationsandimprovingpatientoutcomes.Futureresearchcouldexplorethepotentialbenefitsofimplementingastandardizedprotocolforperipheralvenouscatheterinsertionandmanagementinclinicalsettings.

Overall,thereisaneedforcontinuedresearchonwaystoreduceperipheralvenouscatheterfailureratesandimprovepatientoutcomes.Thedevelopmentofapredictivemodelforcatheterfailureisacrucialfirststepinidentifyingpatientsatriskandimplementingtimelyinterventions.However,additionalresearchisneededtoexplorealternativemethodsforcatheterinsertion,nursingeducationandtrainingprograms,andthedevelopmentofstandardizedprotocols.Byaddressingtheseareas,healthcareprofessionalscanworktowardsreducingtheadverseconsequencesofperipheralvenouscatheterfailureandimprovingpatientoutcomesAnotherkeyareathatneedstobeexploredistheuseoftechnologytoimprovethesuccessrateofperipheralvenouscatheterinsertion.Onesuchtechnologyistheuseofultrasound-guidedcatheterinsertion,whichhasbeenshowntobemoreeffectivethantraditionalcatheterinsertionmethods.Thistechniqueinvolvesusingahandheldultrasoundscannertovisualizetheveinsbeneaththeskin,allowinghealthcareprofessionalstoaccuratelyidentifythebestlocationforcatheterinsertion.Byusingthistechnology,healthcareprofessionalscanimprovethesuccessrateofcatheterinsertion,andtherebyreducetheincidenceofcatheterfailureandassociatedcomplications.

Inadditiontoimprovingcatheterinsertiontechniques,itisimportanttoprovidecomprehensiveeducationandtrainingprogramsforhealthcareprofessionalsinvolvedincatheterinsertionandmaintenance.Theseprogramsshouldcoverthelatestevidence-basedguidelinesandprotocolsforperipheralvenouscatheterinsertionandcare,aswellasprovidepracticaltrainingandsimulationexercisestoreinforcekeyconceptsandskills.Byprovidingongoingeducationandtraining,healthcareprofessionalscanensurethattheyareup-to-datewiththelatestbestpractices,andarethereforebetterequippedtopreventandmanagecatheter-relatedcomplications.

Finally,thedevelopmentofstandardizedprotocolsforperipheralvenouscatheterinsertion,care,andremovalisessentialtoimprovingpatientoutcomesandreducingtheriskofcatheterfailure.Theseprotocolsshouldbeevidence-based,regularlyupdated,andwidelydisseminatedtoallhealthcareprofessionalsinvolvedincatheterinsertionandcare.Byfollowingstandardizedprotocols,healthcareprofessionalscanensurethattheyareprovidingthebestpossiblecaretotheirpatients,andreducingtheriskofadverseeventsassociatedwithcatheterfailure.

Inconclusion,peripheralvenouscatheterfailureisacommonandseriouscompli