發(fā)布時(shí)間：2018-05-11 02:33

  本文選題：護(hù)理中斷事件 + 用藥過程　； 參考：《福建醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的調(diào)查呼吸科用藥過程護(hù)理中斷事件發(fā)生頻率、來源、主體角色、類型及結(jié)局,分析護(hù)理中斷事件相關(guān)影響因素,探索護(hù)理中斷事件有效管理的方法,為臨床護(hù)理用藥安全提供指導(dǎo)。方法使用“呼吸科用藥過程護(hù)理中斷事件登記表”對2014年5月~9月福建醫(yī)科大學(xué)附屬協(xié)和醫(yī)院呼吸科護(hù)士臨床護(hù)理用藥過程所發(fā)生的護(hù)理中斷事件展開現(xiàn)況調(diào)查,主要包括三個(gè)環(huán)節(jié):即醫(yī)囑護(hù)士處理藥物性醫(yī)囑(醫(yī)囑處理)、治療護(hù)士配制藥物(藥物配制)、責(zé)任護(hù)士床邊給藥(給藥執(zhí)行),由研究者本人以直接觀察和問詢的形式進(jìn)行資料數(shù)據(jù)收集,每個(gè)環(huán)節(jié)各觀察36小時(shí),共觀察108小時(shí),主要觀察內(nèi)容為護(hù)理中斷事件來源、主體角色分類、中斷事件類型、中斷事件結(jié)局。建立Excel表格,錄入原始數(shù)據(jù),整理核查后,使用spss22.0軟件進(jìn)行統(tǒng)計(jì)分析。結(jié)果護(hù)理用藥過程觀察108小時(shí)共發(fā)生846次護(hù)理中斷事件,每小時(shí)平均發(fā)生7.8次,其中藥物性醫(yī)囑處理組發(fā)生頻率為每小時(shí)10.8次,藥物配制組發(fā)生頻率為每小時(shí)4.2次,給藥執(zhí)行組發(fā)生頻率為每小時(shí)8.5次。護(hù)理中斷事件主要來源:環(huán)境(26.7%)、家屬(25.5%)、醫(yī)生(15.7%);護(hù)理中斷事件主體角色分類:醫(yī)囑處理組中預(yù)期接受型較多(36.7%),藥物配制組中注意力分散型較多(52.7%),給藥執(zhí)行組中預(yù)期接受型較多(40.5%);護(hù)理中斷事件類型:侵?jǐn)_型多見(42.4%),分心型(26.1%),毀損型(22.8%),矛盾型(8.7%);護(hù)理中斷事件結(jié)局:消極型占89.1%,積極型占10.9%,其中給藥執(zhí)行消極結(jié)局的發(fā)生率最高(97.4%),消極型中主要是增加護(hù)理人員工作負(fù)荷(61.1%),其次是暫停護(hù)理人員的當(dāng)前事務(wù)(29.7%);本研究中因護(hù)理中斷事件產(chǎn)生的12例用藥錯(cuò)誤均為錯(cuò)誤隱患事件,錯(cuò)誤未發(fā)生。醫(yī)囑處理組、藥物配制組及給藥執(zhí)行組除了消極型護(hù)理中斷事件分布差異無統(tǒng)計(jì)學(xué)意義(p0.05)外,護(hù)理中斷事件來源、主體角色、類型及結(jié)局分布差異有統(tǒng)計(jì)學(xué)意義(p0.05)。結(jié)論1.呼吸科用藥過程護(hù)理中斷事件發(fā)生頻率較高。2.呼吸科用藥過程護(hù)理中斷事件來源復(fù)雜,醫(yī)囑處理組主要來源于環(huán)境和醫(yī)生,藥物配制組主要來源于家屬和環(huán)境,給藥執(zhí)行組主要來源于患者、家屬及護(hù)士同事。3.呼吸科用藥過程護(hù)理中斷事件主體角色分類以預(yù)期接受型、主動(dòng)發(fā)起型常見。4.吸科用藥過程護(hù)理中斷事件分類以侵?jǐn)_型為主,其次是分心型。5.呼吸科用藥過程護(hù)理中斷事件消極型結(jié)局常見,少部分為積極型,消極型護(hù)理中斷事件可導(dǎo)致用藥錯(cuò)誤。因此,有效避免或減少護(hù)理用藥過程中不必要的中斷發(fā)生,提高護(hù)士對護(hù)理中斷事件風(fēng)險(xiǎn)評(píng)估的意識(shí),增強(qiáng)抗中斷的心理素質(zhì)及應(yīng)變能力,使用醒目的警示標(biāo)識(shí),設(shè)置專職接待員等措施,對保障護(hù)理用藥安全有重要的意義。
[Abstract]:Objective to investigate the frequency, source, main role, type and outcome of nursing interruption events in the course of respiratory medicine use, analyze the influencing factors of nursing interruption events, and explore the methods of effective management of nursing interruption events. To provide guidance for clinical nursing drug safety. Methods the clinical nursing interruption events of nurses in the Department of Respiratory Medicine were investigated from May to September 2014 by using the Registration form of Nursing interruption in the course of Drug use in the Respiratory Department of the Union Hospital of Fujian Medical University from May to September 2014. It mainly includes three steps: that is, the nurse of the doctor's order deals with the drug's order (doctor's order treatment), the therapeutic nurse compiles the medicine (the medicine is prepared by the nurse), and the responsible nurse's bedside administration (the drug administration is executed), which is observed and questioned directly by the researcher himself. In the form of data collection, Each link was observed for 36 hours and 108 hours. The main observation contents were the source of nursing interruption event, the classification of main role, the type of interruption event and the outcome of interruption event. Establish Excel form, input original data, collate and check, use spss22.0 software for statistical analysis. Results there were 846 nursing interruptions in 108 hours of nursing administration, with an average of 7.8 times per hour. The frequency of occurrence was 10.8 times per hour in the drug treatment group and 4.2 times per hour in the drug preparation group. The frequency of drug administration group was 8.5 times per hour. The main sources of nursing interruption events are as follows: environment 26.7am, family members 25.50.The main role classification of nursing interruption events is as follows: in the order treatment group, the expected acceptance type is more than 36.7%, the attention dispersive type in the drug preparation group is more than 52.7%, and the expectation in the drug administration group is that in the administration group, it is expected in the drug administration group. The types of nursing interruptions were as follows: intrusive type (42.4%), distraction type (26.1g), disfigurement type (22.8N), contradictory type (8.7g); outcome of nursing interruption events: negative type (89.1), positive type (10.9%), among which, the incidence of drug administration was 97.4m, and the highest was 97.4m. In the polar type, the main reason is to increase the working load of nursing staff, and the second is to suspend the current work of nursing staff 29.70.12 cases of medication errors caused by nursing interruption in this study are all hidden trouble events. The error did not occur. There were significant differences in the source, main role, type and outcome of nursing interruption events between the two groups except the negative nursing interruption event distribution (p 0.05), except for the negative nursing interruption events distribution in the medical order treatment group, the drug preparation group and the drug administration execution group (P < 0.05), but there were significant differences in the source, main role, type and outcome distribution of the nursing interruption events. Conclusion 1. The frequency of nursing interruption in the course of medication in respiratory department was higher. 2. 2. The source of nursing interruption events in respiratory department is complex. The medical order treatment group mainly comes from environment and doctor, the drug preparation group mainly comes from family members and environment, and the drug administration group mainly comes from patients, family members and nurses. The main roles of nursing interruption events in respiratory department were classified as expected acceptance type and active initiation type. 4. The classification of nursing interruption events in the course of drug aspiration was mainly intrusive type, followed by distraction type. 5. The negative outcome of nursing interruption events in respiratory department is common, a few are positive type, and negative nursing interruption events can lead to medication errors. Therefore, it is effective to avoid or reduce unnecessary interruptions in the course of nursing medication, to raise nurses' awareness of risk assessment of nursing interruption events, to enhance their psychological quality and ability to cope with interruptions, and to use striking warning signs. It is of great significance to set up full-time receptionist and other measures to ensure the safety of nursing medication.
【學(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R473.5

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