儿科门诊护理给药错误风险预测模型和列线图的构建及分析

Establishment and analysis of risk prediction model and nomogram of pediatric outpatient nursing medication errors

目的分析儿科门诊护理给药错误的影响因素,构建风险预测模型和绘制列线图以帮助儿科门诊护士预防护理给药错误。方法整体抽样选取浙江大学医学院附属儿童医院于2013年1月至2020年12月记录的儿科门诊护理给药患儿516例为研究对象,其中发生护理给药错误患儿172例设为给药错误组,未发生给药错误患儿344例设为非给药错误组,比较分析2组患儿各项指标。结果Logistic回归分析可得,患儿年龄、患儿入学、麻醉镇痛类药物、退热类药物、微量泵静脉注射给药途径、皮下注射给药途径、给药护士护龄、给药护士职称均是儿科门诊护理给药错误的影响因素(P<0.05);构建儿科门诊护理给药错误风险预测模型,使用ROC曲线验证可得,儿科门诊护理给药错误风险预测模型ROC曲线下面积为0.89(95%CI 0.84~0.94,P<0.01),绘制儿科门诊护理给药错误风险预测列线图总分为35~259分,风险率为0.001~0.999,总分越高儿科门诊护理给药错误的风险越高。结论儿科门诊护理给药错误预测模型和列线图构建能够为儿科门诊护理给药错误预防提供参考模型和使用工具,对保障儿科门诊患儿给药安全具有一定的临床价值。

Objective To analyze the influencing factors of nursing medication errors in pediatric outpatient to establish risk prediction model and nomogram for helping pediatric outpatient nurses prevent nursing medication errors.Methods Totally 172 cases of pediatric outpatient nursing children with nursing medication errors were selected from January 2013 to December 2020 in the Children′s Hospital Affiliated to Zhejiang University School of Medicine as the medication error group and 344 cases of children without medication errors as the non-medication error group,and the indicators of the two groups were compared and analyzed.Results According to Logistic regression analysis,children′s age,children′s enrollment,administration of narcotic analgesics,administration of anti-fever drugs,micro pump intravenous route of administration,subcutaneous route of administration,nursing age of administration nurse,title of administration nurse were all significant influencing factors of pediatric outpatient nursing administration errors(P<0.05).To construct the risk prediction model of pediatric outpatient nursing administration error and its AUC area of the model was 0.89(95%CI 0.84-0.94,P<0.01).The total score of the nomogram was 35-259,and the risk rate was 0.001-0.999.The higher the total score was,the higher the risk of medication errors was.Conclusions The establishment of pediatric outpatient nursing medication error prediction model and nomogram can provide reference model and tools for the prevention of pediatric outpatient nursing medication error,which has certain clinical value for ensuring the safety of pediatric outpatient medication.