臨床護士靜脈給藥時間不規(guī)范的相關(guān)因素研究
發(fā)布時間：2018-09-01 15:43
【摘要】：研究目的： 通過調(diào)查某三甲醫(yī)院臨床護士靜脈給藥時間認知現(xiàn)狀,并對臨床靜脈給藥時間執(zhí)行情況進行稽查,分析與靜脈給藥開始時間、靜脈給藥滴速及間隔時間不規(guī)范的影響因素,旨在為臨床管理者制定相關(guān)措施提供依據(jù),進一步規(guī)范臨床靜脈給藥時間。 研究方法： 設計《臨床護士靜脈給藥時間認知情況》問卷,經(jīng)信度檢驗合格后,隨機選取內(nèi)科、外科和監(jiān)護病區(qū)共5個臨床病區(qū),對執(zhí)行靜脈輸液操作的護士進行問卷調(diào)查；設計《臨床護士靜脈給藥時間情況稽查表》,包括靜脈給藥開始時間、靜脈給藥滴速及間隔時間3個部分。對上述調(diào)查病區(qū)中需要靜脈輸液治療的患者,按稽查表逐一核查靜脈給藥時間現(xiàn)狀。收集資料,分別對臨床護士的靜脈給藥時間認知情況調(diào)查部分和臨床稽查部分進行描述性分析,并通過單因素分析以及二分類Logistic多因素回歸方法分析靜脈給藥開始時間、靜脈給藥滴速以及靜脈給藥間隔時間不規(guī)范的影響因素。所有資料均選用SPSS17.0統(tǒng)計軟件進行數(shù)據(jù)的統(tǒng)計分析。 研究結(jié)果： 1.臨床護士靜脈給藥時間認知調(diào)查顯示：整體認知水平在選項為大部分符合以上者比例為87.15%,其中5個條目大部分符合以上比例小于85%,分別是：“了解輸液間隔時間不規(guī)范的危害”認知條目監(jiān)護后二病區(qū)得分最高,急診監(jiān)護病區(qū)最低；“了解三通的使用”認知條目,監(jiān)護后二病區(qū)得分最高,呼吸內(nèi)科病區(qū)最低；“及時調(diào)整輸液滴速至醫(yī)囑范圍”認知條目,監(jiān)護后二病區(qū)得分最高,呼吸內(nèi)科病區(qū)最低；“向患者宣教輸液相關(guān)注意事項”認知條目,監(jiān)護后二病區(qū)得分最高,肝膽胰外科病區(qū)最低；“質(zhì)疑醫(yī)囑輸液滴速的合理性”認知條目,監(jiān)護后二病區(qū)得分最高,呼吸內(nèi)科病區(qū)最低。 2.臨床靜脈給藥時間情況稽查共計556例次,在靜脈給藥開始時間方面,規(guī)范499例(占89.7%),不規(guī)范57例(占10.3%)。在靜脈給藥滴速方面,規(guī)范361例(占64.6%),不規(guī)范例195占(35.4%)。在靜脈給藥間隔時間方面：BID類藥物給藥間隔時間為5.47±1.25h,Q8H類藥物給藥時間間隔為6.37±2.81h,Q12H類藥物給藥間隔時間為9.84±1.54h,Q6H類藥物給藥間隔時間為4.86±3.03h,稽查的54例有靜脈輸液時間間隔要求的輸液藥物中,規(guī)范的25例(占46.3%),不規(guī)范29例的(53.7%)。 3.不同病區(qū)間靜脈給藥開始時間規(guī)范性差異有顯著統(tǒng)計學意義,p=0.000。其中急診監(jiān)護病區(qū)規(guī)范率最高,為97.5%,神經(jīng)內(nèi)二科病區(qū)最低,為76.4%。執(zhí)行護士工齡不同,在靜脈給藥開始時間規(guī)范性差異有顯著統(tǒng)計學意義,p=0.040。其中工齡在11-15年內(nèi)靜脈給藥開始時間規(guī)范率最高為97.4%。不同病區(qū)間靜脈給藥滴速規(guī)范性差異有顯著統(tǒng)計學意義,p=0.000。其中神經(jīng)內(nèi)二科病區(qū)規(guī)范率最高,為98.2%,呼吸內(nèi)科病區(qū)最低,為40.9%。 4.單因素分析顯示：穿刺血管通路類型和單包液體量是影響靜脈給藥滴速規(guī)范的因素。 5.二元Logistic多因素回歸分析結(jié)果顯示,影響靜脈給藥滴速不規(guī)范主要因素為：穿刺血管通路類型中的PICC和CVC以及單包液體量。 結(jié)論： 1.本次調(diào)查中臨床護士整體靜脈給藥時間認知水平較高,其中監(jiān)護后二病區(qū)得分最高。 2.臨床稽查中靜脈給藥滴速不規(guī)范率高于靜脈給藥開始時間不規(guī)范發(fā)生率,但輸液間隔時間不規(guī)范發(fā)生率最高。 3.在靜脈給藥開始時間方面,急診監(jiān)護病區(qū)規(guī)范率最高,神經(jīng)內(nèi)二科病區(qū)最低；其中執(zhí)行輸液的護士工齡在11-15年內(nèi)規(guī)范率最高。在靜脈給藥滴速方面,其中神經(jīng)內(nèi)二科病區(qū)規(guī)范率最高,呼吸內(nèi)科病區(qū)最低。 4.穿刺血管通路類型中的PICC和CVC以及單包液體量是影響靜脈給藥滴速不規(guī)范的因素。
[Abstract]:Research purposes:
By investigating the cognition of intravenous administration time of clinical nurses in a third-class hospital and checking the implementation of clinical intravenous administration time, the influencing factors of irregular beginning time of intravenous administration, intravenous dripping speed and interval time were analyzed, so as to provide basis for clinical managers to formulate relevant measures and further standardize clinical intravenous administration. Administration time.
Research methods:
Design < Cognition of Intravenous Delivery Time of Clinical Nurses > Questionnaire. After passing the reliability test, the nurses who performed intravenous infusion were randomly selected from 5 clinical wards of internal medicine, surgery and surveillance. Design < Checklist of Intravenous Delivery Time of Clinical Nurses > including the beginning time of intravenous administration and intravenous drops. There are three parts: speed and interval. For the patients who need intravenous infusion treatment in the above-mentioned investigation ward, the status of intravenous administration time is checked one by one according to the checklist. The data are collected, and the investigation part of clinical nurses'cognition of intravenous administration time and the clinical examination part are analyzed descriptively, and the single factor analysis and the two-class Lo are used. Influencing factors such as onset time of intravenous administration, intravenous drip rate and irregular interval of intravenous administration were analyzed by gistic multivariate regression. All data were analyzed by SPSS17.0 statistical software.
Research findings:
1. Cognitive survey of intravenous administration time of clinical nurses showed that 87.15% of the total cognitive level accorded with the above items. Most of the five items accorded with the above-mentioned proportion less than 85%. They were "Understanding the harm of irregular infusion interval" and the second ward scored the highest after monitoring, and the emergency ward scored the highest. The cognitive items of "knowing the use of the three links" were the highest in the second ward and the lowest in the respiratory ward after monitoring; the cognitive items of "adjusting the infusion speed to the range of medical orders in time" were the highest in the second ward after monitoring, and the lowest in the respiratory ward; the cognitive items of "educating the patients about the matters needing attention in infusion" were the cognitive items of "educating the patients about the infusion" and the second ward after monitoring. The highest score was in the hepatobiliary and pancreatic surgery ward and the lowest in the respiratory medicine ward.
2. The clinical time of intravenous administration was 556 times, 499 cases (89.7%) were standardized and 57 cases (10.3%) were not standardized. 361 cases (64.6%) were standardized and 195 cases (35.4%) were non-standardized in the rate of intravenous administration. The interval of drug administration was 6.37 [2.81] h, Q12H 9.84 [1.54] h, Q6H 4.86 [3.03] H. Of the 54 cases examined, 25 cases (46.3%) were standardized and 29 cases (53.7%) were not standardized.
3. There was significant difference in the standardization of the beginning time of intravenous administration between different wards (p = 0.000). The standardization rate of emergency ward was the highest (97.5%) and that of neurology ward was the lowest (76.4%). The highest standardized rate of the beginning time of intravenous administration was 97.4%. There was significant difference in the standardized rate of intravenous administration between different disease areas (p=0.000). The highest standardized rate was 98.2% in the neurological ward and 40.9% in the respiratory ward.
4. Univariate analysis showed that the type of puncture pathway and the volume of single package fluid were the factors influencing the drip rate of intravenous administration.
5. The results of binary logistic multivariate regression analysis showed that the main factors influencing the irregular intravenous drip rate were PICC and CVC in the type of puncture vascular access and the volume of single-pack fluid.
Conclusion:
1. In this survey, the clinical nurses'overall cognition level of intravenous administration time was high, and the second ward scored the highest.
2. The rate of irregular intravenous drip rate was higher than the rate of irregular beginning time of intravenous administration in clinical inspection, but the rate of irregular interval of transfusion was the highest.
3. The normative rate of the emergency ward was the highest, and that of the neurology ward was the lowest, and that of the nurses who performed the transfusion was the highest within 11-15 years.
4. PICC, CVC and the volume of single-pack fluid in the type of puncture pathway are the factors that affect the irregular drip rate of intravenous administration.
【學位授予單位】：浙江大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R47
本文編號：2217637
[Abstract]:Research purposes:
By investigating the cognition of intravenous administration time of clinical nurses in a third-class hospital and checking the implementation of clinical intravenous administration time, the influencing factors of irregular beginning time of intravenous administration, intravenous dripping speed and interval time were analyzed, so as to provide basis for clinical managers to formulate relevant measures and further standardize clinical intravenous administration. Administration time.
Research methods:
Design < Cognition of Intravenous Delivery Time of Clinical Nurses > Questionnaire. After passing the reliability test, the nurses who performed intravenous infusion were randomly selected from 5 clinical wards of internal medicine, surgery and surveillance. Design < Checklist of Intravenous Delivery Time of Clinical Nurses > including the beginning time of intravenous administration and intravenous drops. There are three parts: speed and interval. For the patients who need intravenous infusion treatment in the above-mentioned investigation ward, the status of intravenous administration time is checked one by one according to the checklist. The data are collected, and the investigation part of clinical nurses'cognition of intravenous administration time and the clinical examination part are analyzed descriptively, and the single factor analysis and the two-class Lo are used. Influencing factors such as onset time of intravenous administration, intravenous drip rate and irregular interval of intravenous administration were analyzed by gistic multivariate regression. All data were analyzed by SPSS17.0 statistical software.
Research findings:
1. Cognitive survey of intravenous administration time of clinical nurses showed that 87.15% of the total cognitive level accorded with the above items. Most of the five items accorded with the above-mentioned proportion less than 85%. They were "Understanding the harm of irregular infusion interval" and the second ward scored the highest after monitoring, and the emergency ward scored the highest. The cognitive items of "knowing the use of the three links" were the highest in the second ward and the lowest in the respiratory ward after monitoring; the cognitive items of "adjusting the infusion speed to the range of medical orders in time" were the highest in the second ward after monitoring, and the lowest in the respiratory ward; the cognitive items of "educating the patients about the matters needing attention in infusion" were the cognitive items of "educating the patients about the infusion" and the second ward after monitoring. The highest score was in the hepatobiliary and pancreatic surgery ward and the lowest in the respiratory medicine ward.
2. The clinical time of intravenous administration was 556 times, 499 cases (89.7%) were standardized and 57 cases (10.3%) were not standardized. 361 cases (64.6%) were standardized and 195 cases (35.4%) were non-standardized in the rate of intravenous administration. The interval of drug administration was 6.37 [2.81] h, Q12H 9.84 [1.54] h, Q6H 4.86 [3.03] H. Of the 54 cases examined, 25 cases (46.3%) were standardized and 29 cases (53.7%) were not standardized.
3. There was significant difference in the standardization of the beginning time of intravenous administration between different wards (p = 0.000). The standardization rate of emergency ward was the highest (97.5%) and that of neurology ward was the lowest (76.4%). The highest standardized rate of the beginning time of intravenous administration was 97.4%. There was significant difference in the standardized rate of intravenous administration between different disease areas (p=0.000). The highest standardized rate was 98.2% in the neurological ward and 40.9% in the respiratory ward.
4. Univariate analysis showed that the type of puncture pathway and the volume of single package fluid were the factors influencing the drip rate of intravenous administration.
5. The results of binary logistic multivariate regression analysis showed that the main factors influencing the irregular intravenous drip rate were PICC and CVC in the type of puncture vascular access and the volume of single-pack fluid.
Conclusion:
1. In this survey, the clinical nurses'overall cognition level of intravenous administration time was high, and the second ward scored the highest.
2. The rate of irregular intravenous drip rate was higher than the rate of irregular beginning time of intravenous administration in clinical inspection, but the rate of irregular interval of transfusion was the highest.
3. The normative rate of the emergency ward was the highest, and that of the neurology ward was the lowest, and that of the nurses who performed the transfusion was the highest within 11-15 years.
4. PICC, CVC and the volume of single-pack fluid in the type of puncture pathway are the factors that affect the irregular drip rate of intravenous administration.
【學位授予單位】：浙江大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R47
【參考文獻】
相關(guān)期刊論文 前10條
1 侯蘊祈;;腸道內(nèi)輸入高滲鹽水并靜脈輸注大量激素沖擊治療重度低鈉血癥41例的臨床觀察[J];國際醫(yī)藥衛(wèi)生導報;2009年22期
2 陸秀文;徐紅;樓建華;;128起給藥錯誤分析[J];中國護理管理;2011年02期
3 陳妙霞;張俊娥;王雪華;陳華麗;;應用PDCA循環(huán)改進住院病人靜脈輸液管理的探討[J];中國護理管理;2012年02期
4 萬文潔;吳茜;施雁;;臨床護士對給藥錯誤上報態(tài)度的現(xiàn)狀調(diào)查分析[J];中國護理管理;2013年03期
5 邵文利;徐艷;田原;李淑蘭;;靜脈輸液藥液準備及輸液過程安全隱患分析[J];護理管理雜志;2010年10期
6 張明霞;;護士給藥差錯390例的分析及干預對策[J];寧夏醫(yī)學雜志;2012年01期
7 王珊;金如燕;沈蔚;;品管圈在提高時間靜脈用藥準確性中的應用[J];護理學報;2013年01期
8 王微;肖適崎;范玲;;臨床給藥差錯高危環(huán)節(jié)研究[J];護理研究;2012年29期
9 方維軍;陳堅;吳婷婷;黃永鳳;;門急診靜脈輸液不合理應用案例分析及對策[J];藥學服務與研究;2010年01期
10 蘇素紅;吳瀛達;計佩影;;我院靜脈藥物配置中心差錯分析與防范措施[J];中國藥業(yè);2010年08期
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