荆门市二、三级医院住院患者静脉治疗现状调查分析与对策研究

Investigation,analysis and countermeasures of the current situation of intravenous therapy of inpatients in second and third class hospital in Jingmen city

目的了解本地区二、三级医院住院患者静脉治疗现状,并采取干预对策。方法于2013年10月抽取本地区8家二、三级医院30个病区的住院患者和医护人员进行问卷调查与培训,并行静疗质量督导;于2016年8月再次调查医护患静疗知识水平,比较两组医护患静疗知识水平评分和并发症发生情况。结果住院患者静脉治疗管理现状明显改进;经过质控和培训等综合干预,患者静疗并发症的发生率低于干预前(P <0. 05),患者安全现状得到改善;干预后医护患静疗认知水平评分高于干预前(P <0. 05),医护患三方从对静疗规范的不知晓、不关注、不执行和不接受转变为主动参与、主动评估、常态执行、积极配合、主动要求,达到了"知-信-行"的良好效果。结论基层医院住院患者静脉治疗安全现状不容乐观,静脉配制及职业防护方面也存在较多的不足,各级医疗行政主管部门及各医疗机构应积极采取相应措施改善基层医院静脉治疗现状。通过培训和宣传提高了医护患静疗认知水平,并实行医护患共同参与静疗安全的管理模式对提高静脉治疗质量具有重要意义。依托市护理质控中心和护理学会对医护人员实施静疗知识普及培训和静疗护理质量干预,对提高静疗护理质量,保证患者和护理人员的安全切实可行。

Objective To understood the current situation of intravenous treatment of inpatients in the second and third class local hospital, and take intervention measures. Methods To compared the scores of intravenous therapy related knowledge level and complications of hospital, medical staff and patients, inpatients and medical staffs from 30 wards of 8 second and third class local hospital were investigated with questionnaire survey and training, and conducted quality supervision of intravenous therapy in October 2013, and reviewed the knowledge level related to intravenous therapy of hospital, medical staffs and patients in August 2016. Results The status of intravenous therapy management in hospitalized patients has improved significantly. After comprehensive interventions such as quality control and training, the incidence of complications in patients with intravenous therapy was lower than before intervention（ P 〈0.05）, and the safety status of patients was improved. The cognitive level scores of intravenous treatment of doctors, nurses and patients after intervention were higher than before intervention（ P 〈0.05）. Doctors, nurses and patients have changed from ＂ignorance, carelessness, non-execution and non-acceptance to the standard of intravenous treatment to active participation, active assessment, normal implementation, active cooperation, and voluntarily requires, resulting good effect of knowledge-attitude-behavior. Conclusion The safety status of intravenous therapy for inpatients in primary hospitals was no optimistic, and there were also many deficiencies in intravenous deployment and production and occupational protection. Medical administrative departments at all levels and medical institutions should actively take corresponding measures to improve the status of intravenous treatment in primary hospitals. The level of awareness of intravenous therapy in hospitals, medical staff and patients has been improved through training and advocacy. The implementation of the management model of hospitals, medical staff and patients participating in intravenous therapy was of great significance to improve the quality of intravenous therapy. Relying on the city quality control center of nursing and nursing society to impart the knowledge of intravenous therapy and training of nursing quality intervention of intravenous therapy could improve the quality of nursing for intravenous treatment, and ensure the safety of patients and medical staff.