摘要
目的探讨血管通路护士分级授权管理对穿刺复杂动静脉内瘘安全性的影响。方法选择2017年1月至2018年12月使用复杂动静脉内瘘作为血管通路进行维持性血液透析治疗的患者,按照穿刺护士级别分为专家级通路护士组(穿刺试验组)和精通级通路护士组(穿刺对照组),比较2组通路护士一次穿刺成功率、泵控血流量、穿刺点渗血及皮下血肿发生率、穿刺疼痛评分、患者满意度及内瘘并发症发生等情况。结果试验组患者的穿刺成功率、泵控血流量明显优于对照组(P<0.05),穿刺点渗血及皮下血肿发生率明显低于对照组(P<0.05)。试验组患者穿刺疼痛评分显著低于对照组(2.73±1.34 vs.3.67±1.49,P=0.013),满意度评分明显高于对照组(4.73±0.52 vs.3.97±0.62,P=0.001)。试验组患者并发症发生情况低于对照组,差异有统计学意义(P=0.024)。结论血管通路护士分级授权管理可以有效提高复杂动静脉内瘘穿刺效果,降低内瘘并发症的发生。
Objective To investigate the effects of hierarchical authorization management of vascular access nurses on the safety of complex arteriovenous fistula puncture.Methods The patients who were treated by taking complex arteriovenous fistula as vascular access for maintenance hemodialysis in our hospital from January 2017 to December 2018 were enrolled in the study.According to the level of puncture of nurses,who were divided into expert pathway nurses group(experimental group)and proficient pathway nurses group(control group).The one-time puncture success rate,pumping control blood flow,incidence of penetration and subcutaneous hematoma at puncture site,puncture pain score,patient satisfaction and fistula complications were observed and compared between the two groups.Results The puncture success rate and blood flow in experimental group were superior to those in control group(P<0.05),and the incidence of penetration and subcutaneous hematoma at the puncture site were significantly lower than those in control group(P<0.05).Moreover the puncture pain scores in experimental group were significantly lower than those in control group,however,the satisfaction degree scores were significantly higher than those in control group(P<0.01).In addition the incidence rate of complications in experimental group significantly lower than those in control group(P<0.05).Conclusion The hierarchical authorization management of vascular access nurses can effectively improve the puncture effect of complex arteriovenous fistula and reduce the incidence rate of fistula complications.
作者
肖光辉
王玉柱
詹申
张闻娣
张丽红
XIAO Guanghui;WANG Yuzhu;ZHAN Shen(Department of Nephrology,Haidian Hospital(The Third Hospital of Beijing University),Beijing 100080,China)
出处
《河北医药》
CAS
2021年第4期628-630,634,共4页
Hebei Medical Journal
关键词
动静脉内瘘
血管通路护士
分级授权管理
arteriovenous fistula
vascular access nurse
hierarchical authorization management
