集束化策略在抗真菌药物静脉输液安全管理中的应用

Application of bundled strategies in safety management of intravenous administration of antifungal agents

目的运用集束化策略减少抗真菌药物静脉输液过程中护理不良事件的发生风险。方法运用集束化策略开展抗真菌药物静脉输液安全管理,包括实施专项小组管理、制定应用规范、专区标识放置、人员专项培训、科学双人核对,选择正确输液途径和工具及药物不良反应的识别和处理方法等。比较集束化策略开展前(2017年3月—8月)和开展后(2017年9月—2018年2月)抗真菌药物配制和输注过程中护理不良事件的发生率。结果集束化策略开展前和开展后分别记录抗真菌药物静脉输注1518次和1721次。实施集束化策略后,摆药错误、药液浑浊、药物结晶、输液器错误和药液外渗的发生率较实施集束化策略前降低,差异有统计学意义(P<0.05)。实施集束化策略后,护士对抗真菌药物知识考核平均成绩高于实施前(P<0.01)。结论将集束化护理策略应用于血液科抗真菌药物静脉输液安全管理中,能降低药物配制和输注过程中护理不良事件的发生,提高护理人员对抗真菌药物应用的管理能力。

Objective To investigate the effect of bundled strategies in safety management of intravenous administration of antifungal agents.Methods A bundle of strategies were carried out,including setting up a task force,developing application specifications,placing zone identification,staff training,double-check,appropriative infusion approach and tools,diagnosis of drug-induced adverse reaction.The incidence of nursing adverse events associated with intravenous administration before implementation(from March to August 2017)and after implementation(from September 2017 to February 2018)was observed.Results Totally 1518 times of intravenous administration before implementation and 1721 times of intravenous administration were recorded.There was a decreased rate of drug dispensing mistake,turbid liquids,drug crystallization,inappropriate infusion devices and infusion solution extravasation(P<0.05).Nurses achieved a higher score in assessment of rational use of antifungal agents after implementation of bundled strategies(P<0.01).Conclusion It is required to carry out bundled strategies in safety management of intravenous administration of antifungal agents.The bundled strategies are potentially effective to reduce the nursing adverse events associated with intravenous admixture and infusion,and improve the rational use of antifungal agents among nurses.