省域内医院静脉血栓栓塞症防治现状的调查与分析

Investigation and analysis of current practices in the prevention and treatment of venous thromboembolism within regional hospitals

目的了解省域内医院院内静脉血栓栓塞症(VTE)防治现状,为如何整体提升省域内各医院院内VTE防治管理水平和防治能力提供参考依据。方法采用方便抽样法,对省域内46家医院的538位医务人员进行VTE防治相关问卷调查。结果VTE防治管理体系方面,71.74%的医院成立“医院内VTE防治管理委员会”或类似领导小组;54.35%的医院建立院科两级管理制度。护理管理与患者管理方面,63.04%的医院制定了VTE防治护理质量评价规范和定期进行质量评价;52.17%的医院制定院级VTE患者管理与随访相关制度。信息平台建设方面,50.00%的医院实行VTE风险量表电子化评估;45.65%的医院可经信息系统监控VTE预防情况;36.96%的医院具备临床辅助决策支持系统。工作机制与诊疗流程方面,58.70%的定期修订与更新管理制度与工作流程。二级、三级医院在医院内VTE防治组织架构方面存在差异性(P<0.05)。医务人员对院内VTE防治相关政策、标准等表示非常了解的占比不足20%;未参加过VTE防治系统培训的占比29.37%,仅参加过1次培训的占比15.24%;二级、三级医院医务人员参加培训情况呈现0.05水平差异性,未参加过培训的三级医院人员比例较二级医院高。结论省域内医院内VTE防治管理体系建设需进一步完善;部分医院缺少对VTE防治工作机制和流程管理的总体规划,需按行业防治管理规范、建设指南补短板、持续改进;省域内医院需加强人员培训,提升VTE防治认知水平和防治能力,持续优化院内VTE防治管理体系,并保证其高效运转。

Objective To ascertain the present state of in-hospital venous thromboembolism(VTE)prophylaxis and treatment within the specified province to enhance the overall management quality and prevention capabilities of VTE across the province's hospitals.Methods A convenience sampling strategy was employed to administer a VTE prevention-related questionnaire to 538 healthcare professionals within 46 hospitals across the province.Categorical data were analyzed using frequencies and percentages.Chi-square tests were utilized to determine inter-group disparities,with continuity-correctedχ^(2) tests applied for theoretical frequencies below five.Statistical significance was set at a P-value of less than 0.05.Results In VTE prevention management,71.74%of hospitals were established a“Hospital VTE Prevention and Management Committee”or an equivalent leadership group.54.35%of hospitals were implemented a dual-tier management system.For nursing management and patient care,63.04%of hospitals were enacted nursing quality assessment standards for VTE prevention with regular evaluations.52.17%created hospital-based VTE patient management and follow-up protocols.Concerning information platform development,50%implemented electronic VTE risk assessments.45.65%had information systems for monitoring VTE prophylaxis.36.96%maintained clinical decision support systems.About workflow and management mechanisms,58.70%were regularly revising and updating their protocols and systems.Secondary and tertiary hospitals demonstrated significant differences(P<0.05)in their structural organization for in-hospital VTE prevention.Fewer than 20%of medical staff were highly knowledgeable about in-hospital VTE prevention policies and standards.29.37%had never undergone systematic VTE prevention training,while only 15.24%had been trained once.Variability in training uptake was observed between secondary and tertiary hospitals at the 0.05 level,with tertiary hospital staff less likely to have received training.Conclusion The province's in-hospital VTE prevention and management systems require additional enhancement.Some hospitals are deficient in comprehensive planning regarding VTE prevention mechanisms and procedural management.These gaps necessitate improvement following industry prevention management standards and guidelines.There is a pressing need for hospitals to fortify staff training,elevate VTE prevention awareness,amplify preventive capabilities,continually advance the in-hospital VTE prevention management systems,and safeguard their effective functioning.