呼吸科用药护理中断事件现况调查分析

A survey on nursing interruption during medication administration process in respiratory department

目的调查呼吸科用药过程护理中断事件的现况，并分析相关影响因素，为提高护理安全给药提供指导。方法观察2014年6～9月呼吸科护士临床护理用药过程3个主要环节（医嘱处理、药物配置、给药执行）中所发生的护理中断事件．并分析其发生频率、来源、类型及结局。结果用药过程平均发生护理中断事件频率为7．8次／h，主要来源为环境（26．7％）、家属（25．5％），类型以侵扰型（42．4％）、分心型（26．1％）为主，消极结局的发生率最高（89．1％），护理中断事件来源、类型及结局分布差异有统计学意义（P〈0．05）。结论呼吸科用药过程护理中断事件发生频率高、来源多、原因复杂、除少部分有积极意义外以消极影响常见。避免或减少护理用药过程中不必要的中断，对保障护理给药安全有积极的意义。

Objective To investigate the current status of nursing interruption during medication administration process in respiratory department in order to provide guidance in improving patient safety. Methods A direct obser- vation study was conducted to document the frequency,source,type and outcome of nursing interruption in respira- tory department during 3 critical stages of medication administration （order processing,medicine dispensing,medica- tion administering） from June to September 2014. Results The rate of nursing interruption during medication admin- istration was on average 7.8 times per hour,and the source was environment（26.7%） and family members（25.5%）. The major type of interruption were the intrusion type（42.4%） and distracting （26.1%）,and 89.1% of interruption led to negative impacts. Multivariate analysis showed statistically significant difference in source,type and outcome（P〈0.05）. Conclusion Nursing care is frequently interrupted during medication administration in respiratory department with multiple sources and complicated causes,which decreases efficiency and leads to adverse events. Efforts should be made to reduce work interruption to maximize medication administration safety.