呼吸科用药过程护理中断事件调查研究

发布时间：2018-05-11 02:33

本文选题：护理中断事件 + 用药过程　；参考：《福建医科大学》2015年硕士论文

【摘要】：目的调查呼吸科用药过程护理中断事件发生频率、来源、主体角色、类型及结局,分析护理中断事件相关影响因素,探索护理中断事件有效管理的方法,为临床护理用药安全提供指导。方法使用“呼吸科用药过程护理中断事件登记表”对2014年5月~9月福建医科大学附属协和医院呼吸科护士临床护理用药过程所发生的护理中断事件展开现况调查,主要包括三个环节:即医嘱护士处理药物性医嘱(医嘱处理)、治疗护士配制药物(药物配制)、责任护士床边给药(给药执行),由研究者本人以直接观察和问询的形式进行资料数据收集,每个环节各观察36小时,共观察108小时,主要观察内容为护理中断事件来源、主体角色分类、中断事件类型、中断事件结局。建立Excel表格,录入原始数据,整理核查后,使用spss22.0软件进行统计分析。结果护理用药过程观察108小时共发生846次护理中断事件,每小时平均发生7.8次,其中药物性医嘱处理组发生频率为每小时10.8次,药物配制组发生频率为每小时4.2次,给药执行组发生频率为每小时8.5次。护理中断事件主要来源:环境(26.7%)、家属(25.5%)、医生(15.7%);护理中断事件主体角色分类:医嘱处理组中预期接受型较多(36.7%),药物配制组中注意力分散型较多(52.7%),给药执行组中预期接受型较多(40.5%);护理中断事件类型:侵扰型多见(42.4%),分心型(26.1%),毁损型(22.8%),矛盾型(8.7%);护理中断事件结局:消极型占89.1%,积极型占10.9%,其中给药执行消极结局的发生率最高(97.4%),消极型中主要是增加护理人员工作负荷(61.1%),其次是暂停护理人员的当前事务(29.7%);本研究中因护理中断事件产生的12例用药错误均为错误隐患事件,错误未发生。医嘱处理组、药物配制组及给药执行组除了消极型护理中断事件分布差异无统计学意义(p0.05)外,护理中断事件来源、主体角色、类型及结局分布差异有统计学意义(p0.05)。结论1.呼吸科用药过程护理中断事件发生频率较高。2.呼吸科用药过程护理中断事件来源复杂,医嘱处理组主要来源于环境和医生,药物配制组主要来源于家属和环境,给药执行组主要来源于患者、家属及护士同事。3.呼吸科用药过程护理中断事件主体角色分类以预期接受型、主动发起型常见。4.吸科用药过程护理中断事件分类以侵扰型为主,其次是分心型。5.呼吸科用药过程护理中断事件消极型结局常见,少部分为积极型,消极型护理中断事件可导致用药错误。因此,有效避免或减少护理用药过程中不必要的中断发生,提高护士对护理中断事件风险评估的意识,增强抗中断的心理素质及应变能力,使用醒目的警示标识,设置专职接待员等措施,对保障护理用药安全有重要的意义。
[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.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R473.5

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