A prospective study of learning curve for nursing maintenance of totally implantable venous access port in patients with colorectal cancer

LING Bijuan; ZHANG Yuekui; LAN Huijiao; FANG Sujuan; YE Wenhua; LAI Yifen

doi:10.12104/j.issn.1674-4748.2024.08.004

Abstract：Objective:To investigate the learning curve of nursing maintenance of totally implantable venous access port for patients with colorectal cancer,and to provide references for colleagues who are about to develop this nursing maintenance.Methods:The cumulative sum analysis(CUSUM)was used to analyze the learning curve of nursing maintenance in the colorectal ward of Zhangzhou Affiliated Hospital of Fujian Medical University from February 1 to April 20,2023,in which the same nurse independently completed all the nursing maintenance operations in the infusion port,which had not been done by the nurse before participating in the study.The same nurse independently performed all nursing maintenance operations,which had not been performed independently before the nurse participated in the study.Results:84 consecutive colorectal cancer patients who received continuous maintenance were included in the analysis.The operation time of the nurses ranged from 15.0 to 25.0 min,with an average of 17.8 min.The operation time showed an overall decreasing trend with the accumulation of the number of operation cases.The learning curve was best fitted as a cubic curve,i.e,CUSUM(n)=0.000 47n3-0.081n2+3.372n+10.656(n is the number of cases),R2=0.956.The fitted curve reached its peak when the number of cases was accumulated to the 27th,and then the learning curve was divided into the learning improvement stage and the mastery stage.After the transition to the mastery stage,the operation time of the nurses was significantly shortened[from(19.8±2.6)min to(16.8±1.1)min,P＜0.001].Maintenance operations were successfully completed in both phases,and there was no tube blockage in the infusion port,no redness,swelling,heat and local infection symptoms,and no severe pain and other symptoms.The number of cases of violation of aseptic principles and patient satisfaction were significantly better in the mastery stage than in the learning stage(P＜0.05).One case of blood and fluid leakage occurred in the second case of the learning and improving stage,but there was no such case in the mastering stage.Conclusion:Through CUSUM analysis,it is clear that after accumulating 27 cases of nursing care and maintenance of infusion ports,this operation can be skillfully mastered,and it provides a reference for the colleagues who are going to carry out this operation.