摘要
目的调查某三级甲等(三甲)医院《静脉治疗护理技术规范》(以下简称《规范》)的践行现状。方法 2016年3月16日上午09:00—11:30采用某三甲医院静脉治疗小组设计的《临床静脉治疗调查表》,在全院根据纳入排除标准选择住院患者展开调查。采用SPSS 17.0软件对数据进行分析。结果该院住院患者输液率为76.87%,急诊住院患者输液率高达96.11%。目前临床静脉治疗使用的工具以外周静脉导管即留置针为主,其使用比例达到77.91%,同时存在一次性钢针、经外周静脉置入中心静脉导管、中心静脉导管及输液港等多种输液装置。2 990例患者采用外周静脉导管进行输液治疗,其中78.12%穿刺部位符合《规范》要求;397例患者使用经外周静脉置入中心静脉导管进行输液治疗,其中90.17%穿刺部位符合《规范》要求。住院患者静脉治疗相关并发症发生率为15.08%,药物外渗/药物渗出的发生率为10.06%,导管相关血流感染(catheter-related blood stream infection,CRBSI)的发生率为2.89%。结论该医院住院患者输液率符合全国平均水平,但部分科室输液率仍需进一步控制;临床静脉治疗装置选择合理,但穿刺部位选择不尽规范;临床静脉治疗相关并发症发生率低,应在预防和控制药物外渗/渗出和CRBSI等方面加大力度。医院相关部门应在明确本医疗机构静脉治疗实践现状及相关影响因素的基础上,采用多学科、有效率的培训和督促手段,进一步改善临床静脉治疗实践,促进《规范》的普及和落实。
Objective To investigate the status quo of implementation of Intravenous Practice Standard in a tertiary A hospital in Sichuan. Methods At 09：00-11：30 am, on March 16th, 2016, a questionnaire designed by intravenous team （IV Team） was used to conduct the investigation in all the inpatiets according to inclusion and exclusion criteria. The SPSS 17.0 software was used to perform all statistical analysis. Results The intravenous infusion rate in the hospital was 76.87%, while the rate in Emergency Department peaked up to 96.11%. Indwelling needle was the most common used device for intravenous therapy in clinical practice, which was used in 77.91% of the inpatients, and steel needle, peripherally inserted central catheter （PICC）, central venous catheter, and implantable venous access port were also widely used. Peripheral intravenous catheter was used in 2 990 inpatients, and 78.12% of the puncture sites met the standard; PICC was used in 397 inpatients, and 90.17% of the puncture sites met the standard. The incidence of intravenous infusion related-complications was 15.08%, the incidence of drug exosmosis / exudation was 10.06%, and the incidence of catheter-related blood stream infection （CRBSI） was 2.89%. Conclusions On the whole, the intravenous infusion rate in this hospital accords with the national average level, but the rate in some departments should be controlled. The selection of device for intravenous therapy is reasonable, but the selection of intravenous site should be more standardized. The incidence of intravenous infusion related-complications is low, but the prevention and control of drug exosmosis / exudation and CRBSI should be reinforced. Health care organizations should pay more attention to enforce the Intravenous Practice Standard into practice to promote clinical medical service.
出处
《华西医学》
CAS
2017年第10期1572-1575,共4页
West China Medical Journal
