山东省院内静脉血栓栓塞症预防现状的调查分析

Survey of the current prevention status of hospital acquired venous thromboembolism in Shandong province

目的调查山东省院内静脉血栓栓塞症（VTE）的预防现状，为进一步改善院内VTE防治体系建设、提高VTE预防护理质量提供参考。方法采用自行设计的山东省院内静脉血栓预防现状调查问卷，通过方便抽样的方法对山东省81家二级及以上医院的护理人员进行横断面调查。问卷包括个人一般资料、院内VTE防治现状、护理人员VTE相关知识培训需求3部分内容。有效回收问卷3766份。结果院内VTE防治现状：占59．26％（48／81）的医院成立了多学科协作的vTE防治管理小组，其中76．00％（38／50）的三级医院成立了多学科协作的VTE防治管理小组，32．26％（10／31）的二级医院成立了多学科协作的VTE防治管理小组，差异有统计学意义（r=15．166，P=0．000）；科室已常规使用VTE风险评估量表对住院患者的VTE发生风险进行评估，三级医院对患者实施分级护理预防的科室占80．37％（352／438），二级医院占71．43％（175／245），差异有统计学意义（r=7．120，P=0．008）；各个层级医院科室机械预防配置率均不足70％。培训需求情况：92．11％（3469／3766）的护理人员认为有必要且愿意接受VTE相关知识培训，但不同职称的护理人员接受VTE培训情况差异有统计学意义（Z=-12．607，P=0．000），48．04％（1149／2392）的初级职称护理人员没有接受过VTE相关知识培训。结论临床已开始重视院内VTE的预防，但不同层级的医院VTE防治体系建设水平参差不齐，VTE风险评估量表的选择缺乏统一标准，科室VTE机械预防配置率有待进一步提高，基层护理人员的VTE相关知识培训有待进一步加强。

Objective To investigate the current prevention status of hospital acquired venous thromboembolism（VTE） in Shandong province, to further improve the prevention and control of VTE system, and provide reference for prevention of hospital care to improve the quality of VTE. Methods An electronic questionnaire survey was conducted among nurses in 81 hospitals of Shandong province. The questionnaire mainly included three parts： basic information, the current prevention status of hospital acquired VTE and the training needs of nurses. A total of 3 766 valid questionnaires were recovered. Resuhs 59.26%（48/81） hospitals established muhi-discipinary team to prevent VTE, 76.00% （38/50） of the tertiary hospitals established muhi-discipinary team, which was higher than 32.26% （10/31） of the secondary hospitals, the difference was statistically significant 0（2=15.166, P=0.000）. The VTE risk assessment scale had been routinely used to assess the risk of VTE in hospitalized patients, 80.37% （352/ 438） tertiary hospital departments implemented grading nursing care while 71.43% （175/245） secondary hospitals departments implemented grading nursing care, the difference was statistically significant（X2= 7.120, P=0.008）. Each level hospital mechanical preventive equipment configuration rate was less than 70%. Training needs of nurses： 92.11% （3 469/3 766） nurses believed that it was necessary to organize the VTE related knowledge training for nurses, but there were significant differences in the training of nurses with different professional titles （Z=-12.607, P=0.000）. 48.04% （1 149/2 392） nurses with junior grade professional titles were not trained. Conclusions The hospital attaches great importance to the prevention of hospital acquired VTE, but the construction level of VTE prevention system is unevenness, and primary hospitals should be further reinforced. The risk assessment scale selection lacks of uniform standards, mechanical preventive equipment allocation rate should to be further improved. And the training of primary nurses should be further strengthened.