Progress in prevention and control strategies for peripheral inserted central catheter-related bloodstreams infection_West China Medical Journal

Authors：

MOU Xinping ¹ , TAO Lin ² , FU Yan ³ ,  LI Junying ¹

1. Division of Thoracic Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Cancer Day-Care Unit, Cancer Center, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. Division of Thoracic Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LI Junying, Email: hxoncoljy@126.com

Keywords：

Peripheral inserted central catheter; catheter-related bloodstreams infection; prevention and control strategy; research progress

DOI：

10.7507/1002-0179.202401291

Video：

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Abstract Full text Figures/Tables Video References Cited by

Peripheral inserted central catheter (PICC) is the most commonly used central venous catheter in hospitalized patients, and catheter-related bloodstreams infection (CRBSI) is one of the most serious complications during PICC retention, which can affect patient prognosis and treatment. Reducing the incidence of intravascular CRBSI is one of the goals of medical quality and safety management, which continues to attract the attention of domestic and foreign experts and scholars. Authoritative institutions at home and abroad have successively issued a series of prevention and control guidelines and expert consensus, and related research on risk assessment of CRBSI is also rapidly developing. This article reviews the risk assessment, prevention and control measures, and information monitoring and feedback of PICC-related bloodstreams infection, in order to provide reference for building a PICC-related bloodstreams infection prevention and control system.

Citation： MOU Xinping, TAO Lin, FU Yan, LI Junying. Progress in prevention and control strategies for peripheral inserted central catheter-related bloodstreams infection. West China Medical Journal, 2024, 39(3): 494-499. doi: 10.7507/1002-0179.202401291 Copy

1.	中华护理学会静脉输液治疗专业委员会. 静脉导管常见并发症临床护理实践指南. 中华现代护理杂志, 2022, 28(18): 2381-2395.
2.	O’Grady NP, Alexander M, Dellinger EP, et al. Guidelines for the prevention of intravascular catheter-related infections. Infect Control Hosp Epidemiol, 2002, 23(12): 759-769.
3.	Barrigah-Benissan K, Ory J, Simon C, et al. Clinical factors associated with peripherally inserted central catheters (PICC) related bloodstream infections: a single centre retrospective cohort. Antimicrob Resist Infect Control, 2023, 12(1): 5.
4.	Durand GA, Abat C, Cassir N, et al. Peripherally inserted central catheters: a hidden emerging cause of infection outbreaks. New Microbes New Infect, 2020, 35: 100671.
5.	王春立, 吴思婷, 吴心怡, 等. 经外周置入中心静脉导管相关血流感染预防的最佳证据总结. 中华现代护理杂志, 2022, 28(31): 4324-4330.
6.	Saegeman V, Cossey V, Schuermans A. Reducing central-line-associated bloodstream infections by half: it is possible. J Hosp Infect, 2022, 128: 89-91.
7.	Herc E, Patel P, Washer LL, et al. A model to predict central-line-associated bloodstream infection among patients with peripherally inserted central catheters: the MPC score. Infect Control Hosp Epidemiol, 2017, 38(10): 1155-1166.
8.	Sakai H, Iwata M, Terasawa T. External validation of the Michigan PICC catheter-associated bloodstream infections score (MPC score) for predicting the risk of peripherally inserted central catheter-associated bloodstream infections: a single-center study in Japan. Infect Control Hosp Epidemiol, 2023, 44(3): 480-483.
9.	陶雍, 毛静玉, 薛嵋, 等. 肿瘤患者PICC导管相关血流感染风险预测模型的构建. 中国护理管理, 2022, 22(11): 1718-1721.
10.	唐倩芸, 邢柏. 预测PICC导管相关血流感染风险的列线图模型的建立与验证. 中国医药导报, 2020, 17(36): 45-48.
11.	吉史伍呷, 方进博. 机器学习在心力衰竭病人预后评估中的应用研究进展. 护理研究, 2023, 37(7): 1195-1199.
12.	Centers for Disease Control and Prevention. Updated recommendations on the use of chlorhexidine-impregnated dressings for prevention of intravascular catheter-related infections (2017). Georgia: Centers for Disease Control and Prevention, 2017: 1-15.
13.	O’Grady NP, Alexander M, Dellinger EP, et al. Guidelines for the prevention of intravascular catheter-related infections. The Hospital Infection Control Practices Advisory Committee, Center for Disease Control and Prevention, U. S. Pediatrics, 2002, 110(5): e51.
14.	Gorski LA, Hadaway L, Hagle ME, et al. Infusion therapy standards of practice, 8th edition. J Infus Nurs, 2021, 44(Suppl 1): S1-S224.
15.	Ling ML, Apisarnthanarak A, Jaggi N, et al. APSIC guide for prevention of Central Line Associated Bloodstream Infections (CLABSI). Antimicrob Resist Infect Control, 2016, 5: 16.
16.	蔡虻, 王霞, 孙超, 等. 导管相关感染防控最佳护理实践: 从常规到循证. 中华现代护理杂志, 2020, 26(13): 1681-1687.
17.	Buetti N, Marschall J, Drees M, et al. Strategies to prevent central line-associated bloodstream infections in acute-care hospitals: 2022 update. Infect Control Hosp Epidemiol, 2022, 43(5): 553-569.
18.	Buetti N, Ruckly S, Schwebel C, et al. Chlorhexidine-impregnated sponge versus chlorhexidine gel dressing for short-term intravascular catheters: which one is better? Crit Care, 2020, 24(1): 458.
19.	Timsit JF, Schwebel C, Bouadma L, et al. Chlorhexidine-impregnated sponges and less frequent dressing changes for prevention of catheter-related infections in critically ill adults: a randomized controlled trial. JAMA, 2009, 301(12): 1231-1241.
20.	Eggimann P, Pagani JL, Dupuis-Lozeron E, et al. Sustained reduction of catheter-associated bloodstream infections with enhancement of catheter bundle by chlorhexidine dressings over 11 years. Intensive Care Med, 2019, 45(6): 823-833.
21.	Puig-Asensio M, Marra AR, Childs CA, et al. Effectiveness of chlorhexidine dressings to prevent catheter-related bloodstream infections. Does one size fit all? A systematic literature review and meta-analysis. Infect Control Hosp Epidemiol, 2020, 41(12): 1388-1395.
22.	Frost SA, Alogso MC, Metcalfe L, et al. Chlorhexidine bathing and health care-associated infections among adult intensive care patients: a systematic review and meta-analysis. Crit Care, 2016, 20(1): 379.
23.	Mimoz O, Lucet JC, Kerforne T, et al. Skin antisepsis with chlorhexidine-alcohol versus povidone iodine-alcohol, with and without skin scrubbing, for prevention of intravascular-catheter-related infection (CLEAN): an open-label, multicentre, randomised, controlled, two-by-two factorial trial. Lancet, 2015, 386(10008): 2069-2077.
24.	Huang SS, Septimus E, Kleinman K, et al. Chlorhexidine versus routine bathing to prevent multidrug-resistant organisms and all-cause bloodstream infections in general medical and surgical units (ABATE Infection trial): a cluster-randomised trial. Lancet, 2019, 393(10177): 1205-1215.
25.	Wang H, Tong H, Liu H, et al. Effectiveness of antimicrobial-coated central venous catheters for preventing catheter-related blood-stream infections with the implementation of bundles: a systematic review and network meta-analysis. Ann Intensive Care, 2018, 8(1): 71.
26.	Kramer RD, Rogers MA, Conte M, et al. Are antimicrobial peripherally inserted central catheters associated with reduction in central line-associated bloodstream infection? A systematic review and meta-analysis. Am J Infect Control, 2017, 45(2): 108-114.
27.	Selby LM, Rupp ME, Cawcutt KA. Prevention of central-line associated bloodstream infections: 2021 update. Infect Dis Clin North Am, 2021, 35(4): 841-856.
28.	Hymes JL, Mooney A, Van Zandt C, et al. Dialysis catheter-related bloodstream infections: a cluster-randomized trial of the ClearGuard HD antimicrobial barrier cap. Am J Kidney Dis, 2017, 69(2): 220-227.
29.	Tejada S, Leal-Dos-Santos M, Peña-López Y, et al. Antiseptic barrier caps in central line-associated bloodstream infections: a systematic review and meta-analysis. Eur J Intern Med, 2022, 99: 70-81.
30.	Brunelli SM, Van Wyck DB, Njord L, et al. Cluster-randomized trial of devices to prevent catheter-related bloodstream infection. J Am Soc Nephrol, 2018, 29(4): 1336-1343.
31.	Zacharioudakis IM, Zervou FN, Arvanitis M, et al. Antimicrobial lock solutions as a method to prevent central line-associated bloodstream infections: a meta-analysis of randomized controlled trials. Clin Infect Dis, 2014, 59(12): 1741-1749.
32.	Scrivens N, Sabri E, Bredeson C, et al. Comparison of complication rates and incidences associated with different peripherally inserted central catheters (PICC) in patients with hematological malignancies: a retrospective cohort study. Leuk Lymphoma, 2020, 61(1): 156-164.
33.	中国抗癌协会肿瘤护理专业委员会. 隧道式经外周静脉置入中心静脉导管置管技术专家共识(2022). 中华现代护理杂志, 2023, 29(9): 1121-1129.
34.	Kim IJ, Shim DJ, Lee JH, et al. Impact of subcutaneous tunnels on peripherally inserted catheter placement: a multicenter retrospective study. Eur Radiol, 2019, 29(5): 2716-2723.
35.	Lee JH, Kim ET, Shim DJ, et al. Prevalence and predictors of peripherally inserted central catheter-associated bloodstream infections in adults: a multicenter cohort study. PLoS One, 2019, 14(3): e0213555.
36.	Lee JH, Kim MU, Kim ET, et al. Prevalence and predictors of peripherally inserted central venous catheter associated bloodstream infections in cancer patients: a multicentre cohort study. Medicine (Baltimore), 2020, 99(6): e19056.
37.	Lafuente Cabrero E, Terradas Robledo R, Civit Cuñado A, et al. Risk factors of catheter- associated bloodstream infection: systematic review and meta-analysis. PLoS One, 2023, 18(3): e0282290.
38.	王琴, 郑嘉祺, 陈金, 等. 肿瘤患者PICC导管相关感染危险因素的Logistic回归分析. 中国消毒学杂志, 2020, 37(8): 604-607.
39.	张鸣璐, 刘丽丽, 朱丽娜. 为留置PICC的患者用不同敷料对其医用黏胶相关性皮肤损伤发生及改善情况的影响. 当代医药论丛, 2020, 18(4): 38-41.
40.	许丽莎, 谢素友, 施燕选. 个体化健康教育对乳腺癌PICC置管患者自我管理水平及导管留置时间的影响. 医学食疗与健康, 2021, 19(8): 158-159.
41.	范祖燕, 林金香, 吴丹纯. 微信在携带PICC管出院肿瘤病人延续性护理中的应用. 护理研究, 2016, 30(26): 3283-3285.
42.	Gastmeier P, Geffers C, Brandt C, et al. Effectiveness of a nationwide nosocomial infection surveillance system for reducing nosocomial infections. J Hosp Infect, 2006, 64(1): 16-22.
43.	Hansen S, Schwab F, Behnke M, et al. National influences on catheter-associated bloodstream infection rates: practices among national surveillance networks participating in the European HELICS project. J Hosp Infect, 2009, 71(1): 66-73.
44.	Badia-Cebada L, Peñafiel J, Saliba P, et al. Trends in the epidemiology of catheter-related bloodstream infections; towards a paradigm shift, Spain, 2007 to 2019. Euro Surveill, 2022, 27(19): 2100610.
45.	尚文涵, 李长安, 吴志军, 等. 国家护理质量数据平台的建设、应用及改进建议. 中国卫生质量管理, 2019, 26(3): 前插1, 1-4.
46.	Verberk JDM, Aghdassi SJS, Abbas M, et al. Automated surveillance systems for healthcare-associated infections: results from a European survey and experiences from real-life utilization. J Hosp Infect, 2022, 122: 35-43.
47.	Lin MY, Hota B, Khan YM, et al. Quality of traditional surveillance for public reporting of nosocomial bloodstream infection rates. JAMA, 2010, 304(18): 2035-2041.
48.	Januel JM, Lotfinejad N, Grant R, et al. Predictive performance of automated surveillance algorithms for intravascular catheter bloodstream infections: a systematic review and meta-analysis. Antimicrob Resist Infect Control, 2023, 12(1): 87.
49.	Bessis S, Cassir N, Meddeb L, et al. Early mortality attributable to PICC-lines in 4 public hospitals of Marseille from 2010 to 2016 (revised V3). Medicine (Baltimore), 2020, 99(1): e18494.
50.	Musu M, Finco G, Mura P, et al. Controlling catheter-related bloodstream infections through a multi-centre educational programme for intensive care units. J Hosp Infect, 2017, 97(3): 275-281.
51.	刘美华, 彭剑雄, 仇君, 等. 查检单在PICU中心静脉置管相关性血流感染防控中的应用. 当代护士(中旬刊), 2018, 25(2): 107-110.
52.	尚文涵, 张海燕, 吴志军, 等. 以护理质量控制指标为指引促进医院感染管理持续改进. 中国护理管理, 2021, 21(4): 484-487.

1. 中华护理学会静脉输液治疗专业委员会. 静脉导管常见并发症临床护理实践指南. 中华现代护理杂志, 2022, 28(18): 2381-2395.
2. O’Grady NP, Alexander M, Dellinger EP, et al. Guidelines for the prevention of intravascular catheter-related infections. Infect Control Hosp Epidemiol, 2002, 23(12): 759-769.
3. Barrigah-Benissan K, Ory J, Simon C, et al. Clinical factors associated with peripherally inserted central catheters (PICC) related bloodstream infections: a single centre retrospective cohort. Antimicrob Resist Infect Control, 2023, 12(1): 5.
4. Durand GA, Abat C, Cassir N, et al. Peripherally inserted central catheters: a hidden emerging cause of infection outbreaks. New Microbes New Infect, 2020, 35: 100671.
5. 王春立, 吴思婷, 吴心怡, 等. 经外周置入中心静脉导管相关血流感染预防的最佳证据总结. 中华现代护理杂志, 2022, 28(31): 4324-4330.
6. Saegeman V, Cossey V, Schuermans A. Reducing central-line-associated bloodstream infections by half: it is possible. J Hosp Infect, 2022, 128: 89-91.
7. Herc E, Patel P, Washer LL, et al. A model to predict central-line-associated bloodstream infection among patients with peripherally inserted central catheters: the MPC score. Infect Control Hosp Epidemiol, 2017, 38(10): 1155-1166.
8. Sakai H, Iwata M, Terasawa T. External validation of the Michigan PICC catheter-associated bloodstream infections score (MPC score) for predicting the risk of peripherally inserted central catheter-associated bloodstream infections: a single-center study in Japan. Infect Control Hosp Epidemiol, 2023, 44(3): 480-483.
9. 陶雍, 毛静玉, 薛嵋, 等. 肿瘤患者PICC导管相关血流感染风险预测模型的构建. 中国护理管理, 2022, 22(11): 1718-1721.
10. 唐倩芸, 邢柏. 预测PICC导管相关血流感染风险的列线图模型的建立与验证. 中国医药导报, 2020, 17(36): 45-48.
11. 吉史伍呷, 方进博. 机器学习在心力衰竭病人预后评估中的应用研究进展. 护理研究, 2023, 37(7): 1195-1199.
12. Centers for Disease Control and Prevention. Updated recommendations on the use of chlorhexidine-impregnated dressings for prevention of intravascular catheter-related infections (2017). Georgia: Centers for Disease Control and Prevention, 2017: 1-15.
13. O’Grady NP, Alexander M, Dellinger EP, et al. Guidelines for the prevention of intravascular catheter-related infections. The Hospital Infection Control Practices Advisory Committee, Center for Disease Control and Prevention, U. S. Pediatrics, 2002, 110(5): e51.
14. Gorski LA, Hadaway L, Hagle ME, et al. Infusion therapy standards of practice, 8th edition. J Infus Nurs, 2021, 44(Suppl 1): S1-S224.
15. Ling ML, Apisarnthanarak A, Jaggi N, et al. APSIC guide for prevention of Central Line Associated Bloodstream Infections (CLABSI). Antimicrob Resist Infect Control, 2016, 5: 16.
16. 蔡虻, 王霞, 孙超, 等. 导管相关感染防控最佳护理实践: 从常规到循证. 中华现代护理杂志, 2020, 26(13): 1681-1687.
17. Buetti N, Marschall J, Drees M, et al. Strategies to prevent central line-associated bloodstream infections in acute-care hospitals: 2022 update. Infect Control Hosp Epidemiol, 2022, 43(5): 553-569.
18. Buetti N, Ruckly S, Schwebel C, et al. Chlorhexidine-impregnated sponge versus chlorhexidine gel dressing for short-term intravascular catheters: which one is better? Crit Care, 2020, 24(1): 458.
19. Timsit JF, Schwebel C, Bouadma L, et al. Chlorhexidine-impregnated sponges and less frequent dressing changes for prevention of catheter-related infections in critically ill adults: a randomized controlled trial. JAMA, 2009, 301(12): 1231-1241.
20. Eggimann P, Pagani JL, Dupuis-Lozeron E, et al. Sustained reduction of catheter-associated bloodstream infections with enhancement of catheter bundle by chlorhexidine dressings over 11 years. Intensive Care Med, 2019, 45(6): 823-833.
21. Puig-Asensio M, Marra AR, Childs CA, et al. Effectiveness of chlorhexidine dressings to prevent catheter-related bloodstream infections. Does one size fit all? A systematic literature review and meta-analysis. Infect Control Hosp Epidemiol, 2020, 41(12): 1388-1395.
22. Frost SA, Alogso MC, Metcalfe L, et al. Chlorhexidine bathing and health care-associated infections among adult intensive care patients: a systematic review and meta-analysis. Crit Care, 2016, 20(1): 379.
23. Mimoz O, Lucet JC, Kerforne T, et al. Skin antisepsis with chlorhexidine-alcohol versus povidone iodine-alcohol, with and without skin scrubbing, for prevention of intravascular-catheter-related infection (CLEAN): an open-label, multicentre, randomised, controlled, two-by-two factorial trial. Lancet, 2015, 386(10008): 2069-2077.
24. Huang SS, Septimus E, Kleinman K, et al. Chlorhexidine versus routine bathing to prevent multidrug-resistant organisms and all-cause bloodstream infections in general medical and surgical units (ABATE Infection trial): a cluster-randomised trial. Lancet, 2019, 393(10177): 1205-1215.
25. Wang H, Tong H, Liu H, et al. Effectiveness of antimicrobial-coated central venous catheters for preventing catheter-related blood-stream infections with the implementation of bundles: a systematic review and network meta-analysis. Ann Intensive Care, 2018, 8(1): 71.
26. Kramer RD, Rogers MA, Conte M, et al. Are antimicrobial peripherally inserted central catheters associated with reduction in central line-associated bloodstream infection? A systematic review and meta-analysis. Am J Infect Control, 2017, 45(2): 108-114.
27. Selby LM, Rupp ME, Cawcutt KA. Prevention of central-line associated bloodstream infections: 2021 update. Infect Dis Clin North Am, 2021, 35(4): 841-856.
28. Hymes JL, Mooney A, Van Zandt C, et al. Dialysis catheter-related bloodstream infections: a cluster-randomized trial of the ClearGuard HD antimicrobial barrier cap. Am J Kidney Dis, 2017, 69(2): 220-227.
29. Tejada S, Leal-Dos-Santos M, Peña-López Y, et al. Antiseptic barrier caps in central line-associated bloodstream infections: a systematic review and meta-analysis. Eur J Intern Med, 2022, 99: 70-81.
30. Brunelli SM, Van Wyck DB, Njord L, et al. Cluster-randomized trial of devices to prevent catheter-related bloodstream infection. J Am Soc Nephrol, 2018, 29(4): 1336-1343.
31. Zacharioudakis IM, Zervou FN, Arvanitis M, et al. Antimicrobial lock solutions as a method to prevent central line-associated bloodstream infections: a meta-analysis of randomized controlled trials. Clin Infect Dis, 2014, 59(12): 1741-1749.
32. Scrivens N, Sabri E, Bredeson C, et al. Comparison of complication rates and incidences associated with different peripherally inserted central catheters (PICC) in patients with hematological malignancies: a retrospective cohort study. Leuk Lymphoma, 2020, 61(1): 156-164.
33. 中国抗癌协会肿瘤护理专业委员会. 隧道式经外周静脉置入中心静脉导管置管技术专家共识(2022). 中华现代护理杂志, 2023, 29(9): 1121-1129.
34. Kim IJ, Shim DJ, Lee JH, et al. Impact of subcutaneous tunnels on peripherally inserted catheter placement: a multicenter retrospective study. Eur Radiol, 2019, 29(5): 2716-2723.
35. Lee JH, Kim ET, Shim DJ, et al. Prevalence and predictors of peripherally inserted central catheter-associated bloodstream infections in adults: a multicenter cohort study. PLoS One, 2019, 14(3): e0213555.
36. Lee JH, Kim MU, Kim ET, et al. Prevalence and predictors of peripherally inserted central venous catheter associated bloodstream infections in cancer patients: a multicentre cohort study. Medicine (Baltimore), 2020, 99(6): e19056.
37. Lafuente Cabrero E, Terradas Robledo R, Civit Cuñado A, et al. Risk factors of catheter- associated bloodstream infection: systematic review and meta-analysis. PLoS One, 2023, 18(3): e0282290.
38. 王琴, 郑嘉祺, 陈金, 等. 肿瘤患者PICC导管相关感染危险因素的Logistic回归分析. 中国消毒学杂志, 2020, 37(8): 604-607.
39. 张鸣璐, 刘丽丽, 朱丽娜. 为留置PICC的患者用不同敷料对其医用黏胶相关性皮肤损伤发生及改善情况的影响. 当代医药论丛, 2020, 18(4): 38-41.
40. 许丽莎, 谢素友, 施燕选. 个体化健康教育对乳腺癌PICC置管患者自我管理水平及导管留置时间的影响. 医学食疗与健康, 2021, 19(8): 158-159.
41. 范祖燕, 林金香, 吴丹纯. 微信在携带PICC管出院肿瘤病人延续性护理中的应用. 护理研究, 2016, 30(26): 3283-3285.
42. Gastmeier P, Geffers C, Brandt C, et al. Effectiveness of a nationwide nosocomial infection surveillance system for reducing nosocomial infections. J Hosp Infect, 2006, 64(1): 16-22.
43. Hansen S, Schwab F, Behnke M, et al. National influences on catheter-associated bloodstream infection rates: practices among national surveillance networks participating in the European HELICS project. J Hosp Infect, 2009, 71(1): 66-73.
44. Badia-Cebada L, Peñafiel J, Saliba P, et al. Trends in the epidemiology of catheter-related bloodstream infections; towards a paradigm shift, Spain, 2007 to 2019. Euro Surveill, 2022, 27(19): 2100610.
45. 尚文涵, 李长安, 吴志军, 等. 国家护理质量数据平台的建设、应用及改进建议. 中国卫生质量管理, 2019, 26(3): 前插1, 1-4.
46. Verberk JDM, Aghdassi SJS, Abbas M, et al. Automated surveillance systems for healthcare-associated infections: results from a European survey and experiences from real-life utilization. J Hosp Infect, 2022, 122: 35-43.
47. Lin MY, Hota B, Khan YM, et al. Quality of traditional surveillance for public reporting of nosocomial bloodstream infection rates. JAMA, 2010, 304(18): 2035-2041.
48. Januel JM, Lotfinejad N, Grant R, et al. Predictive performance of automated surveillance algorithms for intravascular catheter bloodstream infections: a systematic review and meta-analysis. Antimicrob Resist Infect Control, 2023, 12(1): 87.
49. Bessis S, Cassir N, Meddeb L, et al. Early mortality attributable to PICC-lines in 4 public hospitals of Marseille from 2010 to 2016 (revised V3). Medicine (Baltimore), 2020, 99(1): e18494.
50. Musu M, Finco G, Mura P, et al. Controlling catheter-related bloodstream infections through a multi-centre educational programme for intensive care units. J Hosp Infect, 2017, 97(3): 275-281.
51. 刘美华, 彭剑雄, 仇君, 等. 查检单在PICU中心静脉置管相关性血流感染防控中的应用. 当代护士(中旬刊), 2018, 25(2): 107-110.
52. 尚文涵, 张海燕, 吴志军, 等. 以护理质量控制指标为指引促进医院感染管理持续改进. 中国护理管理, 2021, 21(4): 484-487.

West China Medical Journal

Progress in prevention and control strategies for peripheral inserted central catheter-related bloodstreams infection

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