临床护士静脉给药时间不规范的相关因素研究
发布时间：2018-09-01 15:43
【摘要】：研究目的： 通过调查某三甲医院临床护士静脉给药时间认知现状,并对临床静脉给药时间执行情况进行稽查,分析与静脉给药开始时间、静脉给药滴速及间隔时间不规范的影响因素,旨在为临床管理者制定相关措施提供依据,进一步规范临床静脉给药时间。 研究方法： 设计《临床护士静脉给药时间认知情况》问卷,经信度检验合格后,随机选取内科、外科和监护病区共5个临床病区,对执行静脉输液操作的护士进行问卷调查；设计《临床护士静脉给药时间情况稽查表》,包括静脉给药开始时间、静脉给药滴速及间隔时间3个部分。对上述调查病区中需要静脉输液治疗的患者,按稽查表逐一核查静脉给药时间现状。收集资料,分别对临床护士的静脉给药时间认知情况调查部分和临床稽查部分进行描述性分析,并通过单因素分析以及二分类Logistic多因素回归方法分析静脉给药开始时间、静脉给药滴速以及静脉给药间隔时间不规范的影响因素。所有资料均选用SPSS17.0统计软件进行数据的统计分析。 研究结果： 1.临床护士静脉给药时间认知调查显示：整体认知水平在选项为大部分符合以上者比例为87.15%,其中5个条目大部分符合以上比例小于85%,分别是：“了解输液间隔时间不规范的危害”认知条目监护后二病区得分最高,急诊监护病区最低；“了解三通的使用”认知条目,监护后二病区得分最高,呼吸内科病区最低；“及时调整输液滴速至医嘱范围”认知条目,监护后二病区得分最高,呼吸内科病区最低；“向患者宣教输液相关注意事项”认知条目,监护后二病区得分最高,肝胆胰外科病区最低；“质疑医嘱输液滴速的合理性”认知条目,监护后二病区得分最高,呼吸内科病区最低。 2.临床静脉给药时间情况稽查共计556例次,在静脉给药开始时间方面,规范499例(占89.7%),不规范57例(占10.3%)。在静脉给药滴速方面,规范361例(占64.6%),不规范例195占(35.4%)。在静脉给药间隔时间方面：BID类药物给药间隔时间为5.47±1.25h,Q8H类药物给药时间间隔为6.37±2.81h,Q12H类药物给药间隔时间为9.84±1.54h,Q6H类药物给药间隔时间为4.86±3.03h,稽查的54例有静脉输液时间间隔要求的输液药物中,规范的25例(占46.3%),不规范29例的(53.7%)。 3.不同病区间静脉给药开始时间规范性差异有显著统计学意义,p=0.000。其中急诊监护病区规范率最高,为97.5%,神经内二科病区最低,为76.4%。执行护士工龄不同,在静脉给药开始时间规范性差异有显著统计学意义,p=0.040。其中工龄在11-15年内静脉给药开始时间规范率最高为97.4%。不同病区间静脉给药滴速规范性差异有显著统计学意义,p=0.000。其中神经内二科病区规范率最高,为98.2%,呼吸内科病区最低,为40.9%。 4.单因素分析显示：穿刺血管通路类型和单包液体量是影响静脉给药滴速规范的因素。 5.二元Logistic多因素回归分析结果显示,影响静脉给药滴速不规范主要因素为：穿刺血管通路类型中的PICC和CVC以及单包液体量。 结论： 1.本次调查中临床护士整体静脉给药时间认知水平较高,其中监护后二病区得分最高。 2.临床稽查中静脉给药滴速不规范率高于静脉给药开始时间不规范发生率,但输液间隔时间不规范发生率最高。 3.在静脉给药开始时间方面,急诊监护病区规范率最高,神经内二科病区最低；其中执行输液的护士工龄在11-15年内规范率最高。在静脉给药滴速方面,其中神经内二科病区规范率最高,呼吸内科病区最低。 4.穿刺血管通路类型中的PICC和CVC以及单包液体量是影响静脉给药滴速不规范的因素。
[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.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R47
本文编号：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.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R47
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