集束化培训《静脉治疗护理操作规范》的效果

Effect of Cluster Training on"Nursing Practice Standards for Intravenous Therapy"

目的观察通过集束化培训静脉治疗规范,对静脉治疗规范化的知晓率、静脉治疗的安全性及不良事件的发生率的影响。方法通过集束化模式集中培训《静脉治疗护理技术操作规范》,设计调查问卷,了解静脉治疗规范化情况,比较培训前后两组在静脉治疗操作规范知晓率、知识来源、是否规范化操作等情况。结果(1)临床护理人员大部分为本科学历、工作年限集中在10 a以下,年龄20~40岁;(2)静脉治疗操作规范知晓率和治疗来源:培训前组静脉知晓率,显著小于培训后组(P<0.01);两组静脉治疗护理规范化操作知识来源:书刊、医院培训、参加学术会议、学术交流,差异有统计学意义(P<0.01),来源于经验差异无统计学意义(P>0.05);培训前组在主动学习静脉治疗操作规范经常、偶尔、从不和培训前后的差异有统计学意义(P<0.05);(3)静脉治疗规范化操作是否规范:培训前组在是否规范化消毒范围、是否对患者进行宣教、是否规范化选用留置针、是否规范化留置针时间、是否规范化使用留置针敷料、是否规范化静脉治疗护理和培训后组具有统计学意义(P<0.05);(4)并发症:两组均未出现致死性、致残性、感染性休克等严重并发症,培训前出现2例脓毒血症,经积极治疗后好转。培训后组静脉炎、感染、药物外渗、非计划拔管、导管相关性血栓、过敏反应均显著低于培训前组(P<0.05)。结论通过临床护士静脉治疗护理治疗规范化培训,减少了不良事件的发生率、提高了患者静脉治疗的安全性。

Objective To explore the effect of cluster training on the awareness rate of intravenous therapy standards,the safety of intravenous therapy and the incidence of adverse events.Methods Cluster training mode was applied inthe training on"Nursing Practice Standards for Intravenous Therapy".A questionnaire was designed to identify the awareness rate,knowledge source and whether practice standards of intravenous therapy were carried out efficiently,and the results before and after the training were compared.Results(1)The majority of nursingpractitioners had lower educational achievements,worked less than 10 years,and aged from 20 to 40.(2)Awareness rate of the standards before the training were significantly lower than that after the training(P<0.01).The sources included books,hospital training,participation in academic conferences,academic exchanges and personal experiences.Results showed there was significant difference in all the sources about the standards before and after the training(P<0.01)except in personal experiences(P>0.05).There was significant difference in the frequency of active learning of intravenous therapy(P<0.05).(3)There were significant differences in the results of the following questions before and after the training(P<0.05):"Do you follow the standards for intravenous therapy?","Is sterilization range clearly identified?","Do you provide essential information to the patients?","Do you follow the rules to select indwelling needles?","Do you specify the time for the use of indwelling needles?","Is the dressing for indwelling needles properly used?"and"Do you standardize the nursing practice of intravenous therapy?".(4)No severe complications appeared,such as death,disability,septic shocks.Two cases of sepsis appeared before training butthe symptoms relieved after active treatment.After training,The occurrence of phlebitis,infection,drug extravasation,unplanned extubating,catheter-related thrombosis,and allergic reaction after the training were significantly lower than those before the training(P<0.05).Conclusion Standardized nursing training for intravenous therapy can reduce the occurrence of adverse events and improve the safety of patients.