专科医院静脉护理现状

Current Situation and Analysis of Intravenous Treatment Nursing in Specialized Hospital

目的通过调查专科医院静脉输液治疗护理现状及相关护理问题,以便针对性地进行培训,落实静脉输液护理质量督查,改善静脉输液护理质量。方法运用中华护理学会静脉治疗护理专业委员会设计的《全国三级甲等医院静脉治疗护理现状调查问卷》进行现场问卷调查和拍摄导管护理状况。结果调研22个临床科室495例输液患者,结果显示:(1)输液工具选择不合理(输注刺激性药物、非单次/单剂量输液患者使用钢针)108人次;(2)输液部件安全连接问题(输液器与输液导管有针连接、无任何输液接头)289人次;(3)输液导管维护欠佳(延长管或接头内有陈旧性积血、输液导管固定不规范)14人次;(4)穿刺部位选择不合理(关节部位穿刺、成人下肢穿刺)45人次;(5)敷贴固定与维护欠佳(敷贴卷边、标识问题、胶布过多、有积血)42人次;(6)静脉输液相关并发症(渗出、穿刺点红肿、静脉炎)5人次。结论临床医院在实施国家卫计委关于《静脉输液治疗护理操作规范》的护理工作中,仍然存在着许多不足之处,甚至存在极大的护理风险,需要加大培训与督查力度,以达到静脉输液治疗的持续质量改进。

Objective To investigate the status quo of intravenous infusion treatment and nursing problems in specialized hospitals so as to train targeted nurses and implement the quality supervision of intravenous infusion nursing to improve the quality of intravenous infusion nursing. Methods The questionnaire of nationalvenous treatment nursing status in first-class hospital designed by Chinese Nursing Association Intravenous Treatment Nursing Specialized Committee was used for on-site questionnaire survey and catheter care status. Results Among the495 cases of transfusion patients in 22 clinical departments of investigation,there were 108 cases with unreasonable selection of transfusion tools（ infusion of stimulant drugs,non single/single dose infusion in patients with needle）,289 cases with connecting problems（ safety transfusion infusion apparatus and the infusion catheter needle connection,no transfusion joint）,14 cases with infusion catheter maintenance problem（ or poor extension tube joint is provided with old blood transfusion catheter,a fixed standard of,45 cases with the unreasonable choice of puncture site（ joint puncture,adult lower limb puncture） people,42 cases with plaster fixation and poor maintenance problem（ sticking edge,tape identification problem,too and there is blood）,and 5 cases with intravenous transfusion related complications（ leakage,puncture point swelling,phlebitis in）. Conclusion There are still many deficiencies and nursing risks in the implementation of the standards of intravenous transfusion designed by the State Planning Commission. Training and supervision efforts should be strengthened in order to achieve continuous quality improvement of intravenous infusion treatment.