《静脉治疗护理技术操作规范》修订前后践行现状比较分析

A Comparative Analysis of the Practice Status before and after the Revision of the"Nursing Practice Standards for Intravenous Therapy"

目的纵向比较《静脉治疗护理技术操作规范》修订前后践行现状,以期进一步推动新标准有效落实。方法分别于2016年3月16日和2023年9月19日对四川省某三级甲等综合医院临床科室、住院患者、注册护士进行问卷调查。结果2016年所有科室均根据标准制订了相关管理制度、工作流程或质控标准,2023年所有科室均根据新标准修订了相关管理制度、工作流程或质控标准。住院患者静脉输液率由76.87%降至75.29%,两次调查急诊科和重症医学科静脉输液率均较高。两次调查住院患者静脉输液装置均以外周静脉导管为主(均>75%),一次性钢针使用率由7.84%降为0。穿刺部位不规范率由18.47%降至3.52%,均以外周静脉导管穿刺部位不规范率占比最高。住院患者静脉输液并发症发生率由15.08%降至3.28%。护士静脉治疗的知识和信念水平明显提升,但行为水平较低。结论标准落实效果较好,但住院患者静脉输液率仍需进一步控制,输液装置选择需持续优化,静脉输液并发症应常态化监测,护士标准培训需强化。

Objective To compare practice status before and after the revision of the"Nursing Practice Standards for Intravenous Therapy",in order to further promote the effective implementation of the new standard.Methods On March 16,2016 and September 19,2023,a questionnaire survey was conducted among departments,inpatients and registered nurses in a tertiary general hospital in Sichuan Province,respectively.Results All departments in 2016 had formulated relevant management system,workflow and quality control standard,and all departments in 2023 had revised the relevant management system,workflow and quality control standard according to the new standard.The intravenous infusion rate was reduced from 76.87%to 75.29%,and the two cases were higher in the emergency department and the intensive care unit.In both surveys,peripheral venous catheters were the main intravenous infusion devices in inpatients(both>75%),and the utilization rate of disposable steel needles decreased from 7.84%to 0.The irregular rate of puncture site decreased from 18.47%to 3.52%,and the irregular rate of peripheral venous catheter puncture site accounted for the highest proportion.The incidence of intravenous infusion complications among inpatients decreased from 15.08%to 3.28%.The level of knowledge and belief in intravenous therapy of nurses was significantly improved,but the level of behavior was low.Conclusion The implementation effect of the standard is good,but the rate of intravenous infusion among inpatients still needs to be further controlled,the selection of infusion devices needs to be continuously optimized,the complications of intravenous infusion should be regularly monitored,and the training of nurses related to the standard needs to be strengthened.