TeamSTEPPS模型在预防心脏术后患者中心静脉导管相关性血流感染中的应用实践OA

Objective To evaluate the efficacy of the team strategies and tools to enhance performance and patient safety(TeamSTEPPS)in improving medical quality and patient safety for preventing central line-associated bloodstream infection(CLABSI)in postcardiac surgery patients,aiming to provide a scientific basis for clinical CLABSI prevention.Methods A total of 400 postcardiac surgery patients with central venous catheter(CVC)admitted to the cardiac surgical intensive care unit(CSICU)of Shandong First Medical University Affiliated Provincial Hospital from May to December 2024 were enrolled as the conventional management group,receiving standard CVC care.Another 408 similar patients admitted from January to August 2025 were assigned to the TeamSTEPPS model management group,receiving prevention strategies based on the TeamSTEPPS framework.The implementation rates of CLABSI prevention measures,CLABSI incidence rates,and CVC usage patterns were compared between the two groups to assess the practical effectiveness of the TeamSTEPPS model in CLABSI management.The model's applicability was further evaluated by analyzing healthcare collaboration within the CSICU and the proficiency of nursing staff in CVC management skills post-model adoption.Results A total of 808 CSICU patients were included,comprising 400 in the conventional management group and 408 in the TeamSTEPPS model management group.Compared with the conventional management group,the TeamSTEPPS model management group significantly improved the implementation rates of preventive measures among patients[hand hygiene compliance rate:95.10%(388/408)vs.78.75%(315/400);maximum aseptic barrier compliance rate:96.81%(395/408)vs.75.75%(303/400);standardized dressing change compliance rate:93.38%(381/408)vs.72.25%(289/400);standardized catheter fixation compliance rate:94.61%(386/408)vs.81.75%(327/400);standardized use of central venous infusion lines and associated devices compliance rate:92.65%(378/408)vs.77.25%(309/400);standardized catheter irrigation and sealing compliance rate:93.63%(382/408)vs.70.25%(281/400);daily assessment of indications for catheter removal compliance rate:95.59%(390/408)vs.67.75%(271/400),all P<0.05].Additionally,both the incidence of CLABSI and the utilization rate of CVC showed significant reductions[CLABSI incidence(cases per 1 000 catheter days):0.554(2/3 609)vs.2.531(9/3 556);CVC utilization rate:90.13%(3 609/4 004)vs.98.31%(3 556/3 617);both P<0.05].The quality of collaboration between medical staff and nursing personnel in the CSICU,as well as their CVC management skills,showed significant improvement[medical-nursing relationship:13.43±0.93 vs.8.96±1.36;joint participation in treatment/nursing decision-making:46.30±1.83 vs.33.67±2.14;patient information communication:36.04±1.52 vs.25.51±1.77;total score:95.77±2.58 vs.68.14±3.08;theoretical knowledge score:45.07±2.24 vs.37.22±2.62;practical skills score:45.91±1.40 vs.39.07±2.44;overall score:90.98±2.70 vs.76.29±3.02;all P<0.05].Conclusions The CLABSI prevention and management model based on TeamSTEPPS significantly improves teamwork efficiency,enhances the implementation of prevention measures,and effectively reduces the incidence of CLABSI in patients after cardiac surgery,providing a scientific and feasible intervention strategy for clinical practice.