| Summary: | 碩士 === 臺北醫學大學 === 護理學研究所 === 93 === Introduction: Because the hemoato-oncological patients receiving frequent central venous catheter injection during treatment course are prone to be threatened by infections; therefore, the purposes of this study were to understand and analyze the differences of blood stream infection rates, service satisfactory rate, and medical costs between the needleless closed system device and the common intravenous lock.
Method: The design was prospective randomized study. Totally, twenty eight patients were enrolled, who received central venous catheter injection therapy in a hemato-oncological ward of medical center in Taipei. Fourteen patients were randomized into the experimental group using needleless closed system device and the other 14 into the control group using intravenous lock. Most patients were diagnosed as lymphoma and acute myeloid leukemia. The average length of hospital for the control group was 3.9days longer than the experimental group (t=-.898; P=.378). There was no significant difference at baseline between groups.
Results: Catheter related blood stream infection occurred in 5 patients. Average catheter related bloodstream infection rate was 1.3 ‰ in the experimental group and 1.95 ‰ in the control group. Infected patients mostly belonged to leukemia and had statistically significant 11.8 days longer hospital stay than control group (t＝2.23; P=.035).
As regarding to the service satisfaction, higher satisfaction rate was found in the control group about the weight of injection connector, size volume, appearance and color. The experimental group had higher satisfaction about the manipulation technique and the education prior to the usage and showed statistical significance (t＝2.841; P= .010 ). However, no significant. difference was found between groups about the entire service.
The cost in experimental group was NT 92,018 dollars with respect to NT 99,930 dollars in the control group. Since the cost increased NT 115,755 dollars in each infection patient, needleless closed system device with higher single unit price had more benefit than usual intravenous lock.
Our study showed appropriate use of needleless closed system device in care of intravenous catheter may decrease the infection rate for hemato-oncological patients, reduce medical cost and improve the quality of patient care.
Key word：Hemato-Oncology, bloodstream infecton, patient satisfaction, cost-effectiveness
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