老年住院患者夜间给药安全的调查

Investigation of hospital oral administration at night among elderly inpatients

目的：了解老年住院患者夜间药物服用情况及其影响因素,减少给药差错的发生。方法采用目的抽样方法,选择三级医院临床一线护士165名和老年患者274例为调查对象,通过对老年患者夜间跟踪调查及护理人员问卷调查,对结果进行Spearman相关性分析,了解影响口服药发放安全的风险因素。结果165名护士夜间安全给药执行情况,发药查对严格执行率最高,占90.9%,发药到口严格执行率最低,占33.3%。患者服用方式、服用时间与护士发药到口执行程度呈正相关（ r值分别为0.407,0.335；P〈0.05）；患者遵医行为、服药姿势与护士对药物知识宣教执行程度呈正相关（r值分别为0.380,0.429；P〈0.05）；患者不良反应处理与护士观察服药后反应的执行程度呈正相关（r=0.464,P〈0.05）。结论指导老年患者正确服用药物、提高其遵医行为应该作为老年患者健康教育的重要内容,开展对护理人员全面系统的药物相关知识培训,增加护士药品知识的储备能力也是降低夜间给药风险的必要措施。

Objective To ensure the safety of oral administration at night among elderly inpatients. Methods By the purposive sampling method, a total of 165 clinical nurses and 274 elderly patients were selected as sample. Elderly patients received nocturnal tracking and 165 nurses underwent survey questionnaire, that investigate risk factors for night safety of oral-administration. Results For circumstances of night oral medicine administration among 165 nurses, the rate of medicine inspection was highest （90. 9%）, while the implementation rate of putting medicine into mouth was lowest （33. 3%）. Drug regimen and administration time of elderly patients had positive correlation with the implantation level of putting medicine in the mouth by nurses （r=0.407, 0. 335;P 〈 0. 05）. The compliance and posture of medication administration had positive correlation with medicine knowledge education to patients by nurses （r=0. 380, 0. 429;P〈0. 05）, and the adverse reactions of patients was positively correlated with nurses observed after taking the drug （r=0. 464,P〈0. 05）. Conclusions We should focus on guiding elderly patients to take medicine correctly and compliance of medicine order, and carry out the training of comprehensive drug knowledge for nurses to decrease the risks of night medicine administration.