与无针输液接头相关的导管相关性血流感染风险评估工具的构建与初步应用

doi:10.3761/j.issn.0254-1769.2026.09.003

中华护理杂志 ›› 2026, Vol. 61 ›› Issue (9): 1171-1179.DOI: 10.3761/j.issn.0254-1769.2026.09.003

• 静脉通路装置留置及维护专题 • 上一篇下一篇

与无针输液接头相关的导管相关性血流感染风险评估工具的构建与初步应用

黄萍¹(), 李黎¹^,^*(), 郭骊莉¹, 徐莹¹, 叶赟², 江淑芳³

¹ 常州市第一人民医院肿瘤放射治疗科常州市 213000
² 常州市第一人民医院护理部常州市 213000
³ 常州市第一人民医院感染管理科常州市 213000

收稿日期:2025-09-22 出版日期:2026-05-10 发布日期:2026-04-30
*通讯作者: 李黎，E-mail：389629831@qq.com
作者简介:黄萍：女，本科，主管护师，E-mail：907593119@qq.com
第一联系人：作者贡献声明
黄萍、郭骊莉、徐莹：设计及实施研究、采集及分析数据、撰写及修改论文；李黎：酝酿及设计研究、实施研究、撰写及修改论文；叶赟、江淑芳：酝酿及设计研究、技术支持
基金资助:
2023常州市第一人民医院科技计划项目(yy2023003)

Construction and preliminary application of a risk assessment tool for central line associated bloodstream infections with needle-free connectors

HUANG Ping¹(), LI Li¹^,^*(), GUO Lili¹, XU Ying¹, YE Yun², JIANG Shufang³

¹ Department of Radiation Oncology， Changzhou First People’s Hospital， Changzhou 213000， China
² Nursing Department， Changzhou First People’s Hospital， Changzhou 213000， China
³ Hospital Infection Management Department， Changzhou First People’s Hospital， Changzhou 213000， China

Received:2025-09-22 Online:2026-05-10 Published:2026-04-30
* Corresponding author: LI Li，E-mail：389629831@qq.com
Funding program:
Science and Technology Plan Project of Changzhou First People’s Hospital，2023(yy2023003)

摘要/Abstract

摘要：

目的构建与无针输液接头相关的导管相关性血流感染风险评估工具并进行初步应用。方法通过文献分析、德尔菲专家函询、层次分析、主次因分析法和预调查形成评估工具初稿，便利选取2025年10—11月常州市某三级甲等综合医院使用中心静脉导管且导管末端连接无针输液接头的200例住院患者，对其使用的无针输液接头进行风险因素评估，检验工具的信效度。采用自身前后对照设计，对48名使用该工具的护士进行无针输液接头间歇性给药后消毒知信行问卷调查，评价其应用效果。结果该风险评估工具包含药物特性、接头情况、患者与导管置管因素、临床实践环境因素4个维度、共11个条目，总的Cronbach’s α系数为0.831，内容效度指数为0.930，各维度相关性为0.440~0.557（均P<0.05）。验证性因子分析显示，模型适配度各检验量均在可接受范围内。护士应用该工具后，相关知识、态度、行为各维度得分及总分分别为25.00（20.00，25.00）、16.00（16.00，18.00）、24.00（22.00，24.00）、63.00（60.00，65.00）分，高于应用前（均P<0.001）。结论构建的与无针输液接头相关的导管相关性血流感染风险评估工具信效度良好，能强化护士在间歇性给药后消毒等关键操作环节的风险意识、积极态度，并促进操作规范性。

Abstract:

Objective To develop and preliminarily apply a risk assessment tool for central line associated bloodstream infections（CLABSI） associated with needle-free connectors. Methods The draft tool was developed through literature review，Delphi expert consultation，Analytic Hierarchy Process（AHP），and ABC classification. A convenience sample of 200 inpatients with central venous catheters connected to needle-free connectors was selected from a tertiary hospital in Changzhou，between October and November 2025. Risk factors pertaining to the needle-free connectors were assessed to examine the tool’s reliability and validity. A self-controlled before-after design was adopted，in which a knowledge，attitude，and practice（KAP） questionnaire survey on the disinfection of needle-free connectors after intermittent medication administration was conducted among 48 nurses who used the tool，to evaluate its application effect. Results The final tool comprises 4 dimensions（medication characteristics，connector status，patient and catheter factors，clinical practice environment） and 11 items. The overall Cronbach’s α coefficient was 0.831，and the content validity index was 0.930. Inter-dimension correlations ranged from 0.440 to 0.557（all P<0.05）. Confirmatory factor analysis indicated acceptable model fit indices. After using the tool，nurses’ scores significantly increased in knowledge 25.00（20.00，25.00），attitude 16.00（16.00，18.00），practice 24.00（22.00，24.00） dimensions and total score 63.00（60.00，65.00） compared to preintervention levels（all P<0.001）. Conclusion The risk assessment tool for needle-free connector associated CLABSI developed in this study demonstrated good reliability and validity. It can enhance nurses’ risk awareness，positive attitudes，and operational compliance in key procedures such as post-intermittent medication disinfection.

Key words: Needle-Free Connector, Central Line Associated Bloodstream Infections, Risk Assessment, Reliability, Validity, Nursing Care

黄萍, 李黎, 郭骊莉, 徐莹, 叶赟, 江淑芳. 与无针输液接头相关的导管相关性血流感染风险评估工具的构建与初步应用[J]. 中华护理杂志, 2026, 61(9): 1171-1179.

HUANG Ping, LI Li, GUO Lili, XU Ying, YE Yun, JIANG Shufang. Construction and preliminary application of a risk assessment tool for central line associated bloodstream infections with needle-free connectors[J]. Chinese Journal of Nursing, 2026, 61(9): 1171-1179.

图/表 3

表1 与无针输液接头相关的导管相关性血流感染风险评估工具重要性赋值及权重

Table 1 Importance ratings and weights of the risk assessment items for central line associated bloodstream infections associated with needle-free connectors

表2 与无针输液接头相关的导管相关性血流感染风险评估工具风险等级划分

Table 2 Risk level classification of the assessment tool for central line associated bloodstream infections associated with needle-free connectors

表3 评估工具使用前后护士无针输液接头间歇性给药后消毒知信行问卷得分[n=48，分，M（P25，P75）]

Table 3 Knowledge，attitude and practice analysis of nurses’ disinfection after intermittent administration of needle-free connectors before and after using the assessment tool[n=48，score，M（P25，P75）]

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与无针输液接头相关的导管相关性血流感染风险评估工具的构建与初步应用

Construction and preliminary application of a risk assessment tool for central line associated bloodstream infections with needle-free connectors

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