我国临床护士胰岛素注射操作实地评价现状及影响因素

Status quo and influencing factors of on-site evaluation of insulin injection operation for clinical nurses in China

目的:调查我国临床护士胰岛素注射行为现状及影响因素。方法:于2019年7月—9月,采用便利抽样法,在全国范围内选取77所医院及1 666名护士进行调查。调查问卷包括科室一般资料、护士胰岛素注射行为核查问卷、胰岛素管理核查单及护士胰岛素注射知信行问卷。结果:护士胰岛素注射行为标准化得分为(84.15±15.39)分,整体情况良好,注射行为良好者1 061人(63.69%),一般471人(28.27%),差134人(8.04%);67.75%护士所在科室有胰岛素管理质控记录。多因素分析显示,科室每日胰岛素注射人次、床护比、科室、区域、医院级别是胰岛素注射行为标准化得分的影响因素(P<0.05)。835名护士胰岛素注射知识、信念和行为得分分别为(14.59±3.09)分、(17.64±2.45)分、(83.72±7.55)分。Pearson相关分析显示,护士胰岛素注射知识、信念和行为得分与胰岛素注射行为标准化得分之间呈正相关(P<0.05)。结论:临床护士胰岛素注射水平有待进一步规范,胰岛素管理水平存在不足,需对护士胰岛素注射和管理开展规范化、同质化培训和督导工作。

Objective:To survey the status quo and influencing factors of insulin injection behavior in clinical nurses. Methods:From July to September 2019,convenience sampling was used to select and survey 77 hospitals across the country,and 1 666 nurses were surveyed on the spot. The field survey questionnaire included general information of the department,nurses’ insulin injection behaviors questionnaires,insulin management checklists,and nurses’ knowledge,attitude and practice of insulin injections questionnaires. Results:The standardized score of insulin injection in nurses was 84. 15±15. 39,and the overall condition was good. There were 1 061 nurses(63. 69%)with good injection behavior,471 nurses(28. 27%)with general injection behavior,and 134 nurses(8. 04%)with poor injection behavior. 67. 75% of the nurses’ departments had quality control records of insulin management. Multivariate analysis showed that the total number of daily insulin injections in the department,bed-to-care ratio,department,region,and hospital level on the day were the influencing factors for the standardized score of insulin injection behavior(P<0. 05). The scores of insulin injection knowledge,belief and behavior of835 nurses were 14. 59±3. 09,17. 64±2. 45,and 83. 72±7. 55,respectively. Pearson correlation analysis showed that there were positive correlation between the scores of nurses’ insulin injection knowledge,attitude and practice and the standardized scores of insulin injection behavior(P<0. 05). Conclusions:The level of insulin injection of clinical nurses needs to be further standardized,and there are many problems in the level of insulin management. It is necessary to carry out standardized and homogeneous training and supervision of insulin injection and management.