静脉输液专科护理巡查在临床输液风险前馈控制中的作用

Effect of monitoring of transfusion specialist nursing in clinical transfusion risk of former feedback control

目的探讨静脉输液专科护理巡查在专科护理质量管理中的实践与效果。方法静脉输液治疗护理小组运用前馈控制的理论和方法，在2014、2015、2016年每年采用横断面调研方法及静脉输液专项质量查检表全面了解全院输液工具选择的情况及质量。建立和完善静脉输液相关治疗制度及操作流程，制订月质量控制计划，每月有计划对全院各科室进行静脉输液专科护理质量巡查并及时反馈。结果全院输液工具的合理选择更加合理，钢针比例2016年分别比2015年和2014年下降了8．9％（321／920—212／846）和18．8％（321／920—156／968），静脉输液质量在导管固定规范性、护理人员对专科技能掌握及相关的专科知识掌握率明显提高，静脉输液治疗相关的并发症二级以上静脉炎的例数2016年分别比2015年和2014年减少22例和30例，药物外渗例数2016年分别比2015年和2014年减少18例和31例。结论静脉输液专科护理巡查对护理质量持续改进具有很好的促进作用，前馈控制是静脉输液治疗质量管理的有效手段。

Objective To investigate the practice and effect of specialist nursing inspection of intravenous infusion in the quality control of specialist nursing. Methods Intravenous infusion treatment nursing group used feed-forward control theory and methods, taking cross-sectional research methods yearly from 2014 to 2016 and referencing intravenous infusion special quality checklist to fully understand the hospital infusion tool selection situation and quality. Intravenous infusion related treatment system operational procedures was established and improved, the monthly quality control plan was made to do quality nursing of intravenous infusion specialist inspections and timely feedback of each month to various sections of the hospital. Results The rational choice of the hospital infusion tool was more reasonable. The proportion of steel needle in 2016 compared with in 2015 and 2014 was decreased by 8.9%（321/920- 212/846）, 18.8% （321/920-156/968）. Intravenous infusion quality was significantly improved in the catheters＇ normative fix, nursing staffs＇ mastery of the skills and related expertise control rate, intravenous infusion treatment-related complications e.g. Phlebitis above grade two in 2016 were reduced 22 cases and 30 eases compared with in 2015 and in 2014, meanwhile the number was 18 and 31 in drug extravasation ease. Conclusions Special nursing of intravenous infusion has a good effect on the improvement of nursing quality, and feed-forward control is an effective method for quality control of intravenous infusion therapy.