医院手术护理给药错误风险因素分析与预测模型建立

Establishment and Analysis of the Wrong Prediction Model of Surgical Nursing Administration in the Third Class A Hospital

目的 分析医院手术中发生护理给药错误的影响因素,建立风险预测模型以降低手术中护士护理给药错误。方法 选取某三甲医院于2021年1月-2022年1月记录手术中发生护理给药错误患者534例(设为给药错误组)和未发生给药错误患者1 068例(设为非给药错误组),比较分析两组患者各项指标的差异,使用Logistic回归分析手术中发生护理给药危险因素和建立预测模型并绘制列线图。结果 该院手术中护理给药错误率为6.25%。Logistic回归方程可得,年龄(OR=4.208,95%CI=5.319~24.613)、给药抗生素(OR=2.604,95%CI=1.238~6.444)、给药麻醉药(OR=2.404,95%CI=1.024~6.693)、微量泵静脉注射(OR=0.277,95%CI=0.018~0.584)、皮下注射(OR=1.950,95%CI=1.087~5.859)、手术类型(OR=3.504,95%CI=1.439~6.386)、给药护士护龄(OR=0.520,95%CI=0.290~0.934)、给药护士职称(OR=0.491,95%CI=0.334~0.721)和配备专职麻醉护士(OR=0.527,95%CI=0.067~0.758)纳入手术中护理给药错误风险预测模型(P<0.05)。基于预测模型绘制列线图,手术中护理给药错误风险预测列线图总分为140~308分,风险率为0.001~0.999。结论 手术中护理给药错误受到年龄、给药类型、给药途径、手术类型、给药护士护龄及职称和配备专职麻醉护士的影响,应根据影响因素采取相应措施降低手术中护理给药错误发生。

Objective To analyze the influencing factors of nursing medication errors during operation and draw a nomogram to help nurses prevent nursing medication errors during operation in major hospitals in Shanghai city.Methods 534 patients with nursing medication errors during operation were selected as medication error group and 1 068 patients without medication errors were selected as non-medication error group from January 2021 to January 2021 in our hospitals.The indicators of the two groups were compared and analyzed.Logistic regression analysis was used to analyze the influencing factors of nursing medication during operation and establish nomogram.Results The error rate of nursing administration in 5 major hospitals in Shanghai was 6.25%.The logistic regression equation showed that age(OR=4.208,95%CI=5.319-24.613),antibiotics(OR=2.604,95%CI=1.238-6.444),anesthetics(OR=2.404,95%CI=1.024-6.693),while the route of intravenous administration with micropump(OR=0.277,95%CI=0.018-0.584),subcutaneous injection route of Administration(OR=1.950,95%CI=1.087-5.859),operation type(OR=3.504,95%CI=1.439-6.386),nurse's age(OR=0.520,95%CI=0.290~0.934),the title of dosing nurse(OR=0.491,95%CI=0.334-0.721)and allocation of full-time anesthesia nurse(OR=0.527,95%CI=0.067-0.758)were included in risk prediction model of surgery nursing medication errors(P<0.05).The nomogram score was drawn based on the prediction model to describe the risk of nursing medication errors in surgery.The total score of the prediction nomogram was 140-308,and the risk rate was 0.001-0.999.The total score was 140-308,and the risk rate was 0.001-0.999 on the nomogram.Conclusion Nursing administration errors during operation are affec-ted by age,type of administration,route of administration,type of operation,nurse age and professional title of administration nurses,and the allocation of full-time anesthesia nurses.Corresponding measures should be taken according to the influencing factors to reduce the occurrence of nursing administration errors during operation.