基层医院血管通路装置选择现况及影响因素分析

Current status of the choice of vascular access devices and analysis of its influencing factors in primary hospitals

目的调查基层医院血管通路装置(VAD)选择的现况及影响选择的因素,为管理者促进静疗标准落实,合理选择VAD提供参考依据。方法自行设计调查问卷,采用便利调查的方式,对基层医院562名从事静脉治疗的护士进行调查。基于VAD的选择结果,将护士分为头皮针组、留置针组和其他组。结果基层医院使用频率最高的VAD为头皮钢针,占70.82%,社区静疗护士VAD选择倾向于头皮针(P<0.05);头皮针组护士倾向于根据患者的静脉条件和操作的成功率选择VAD(P<0.05);头皮针组护理人员参加静疗的培训机会明显低于留置针组和其他组(P<0.05)。结论基层医院护理管理者应控制护理人员的工作强度,加强对护理人员静疗相关知识的培训,改变护理人员对VAD选择的理念和态度,加强主动静脉评估,合理选择VAD,保障患者输液安全,提高护理服务质量。

Objective To investigate the current status of the choice of vascular access devices(VAD)in primary hospitals and the factors influencing the selection,and to provide a reference basis for managers to promote the implementation of the standard of static therapy and rationally choose VAD.Methods A self-designed questionnaire was used to investigate 562 nurses engaged in intravenous treatment in primary hospitals by adopting a convenient investigation method.Based on the results of VAD selection,the nurses were divided into a scalp needle group,a indwelling needle group,and other groups.Results The most frequently used VAD in primary hospitals was scalp steel needles,accounting for 70.82%,so the nurses of community static therapy were inclined to chose scalp needles for VAD(P<0.05),and the nurses of scalp needle group tended to choose VAD based on the patient's vein conditions and operation success rate(P<0.05).The training opportunities for nursing staff in the scalp needle group were significantly lower than those in the indwelling needle group and other groups(P<0.05).Conclusion The nursing managers in primary hospitals should control the work intensity of nursing staff,strengthen the training of nursing staff related to intravenous treatment,change the concept and attitude of nursing staff on VAD selection,strengthen active venous assessment,rationally select VAD,and ensure the safety of patient infusion to improve the quality of nursing services.