中华护理杂志 ›› 2022, Vol. 57 ›› Issue (7): 785-790.DOI: 10.3761/j.issn.0254-1769.2022.07.003

• 血液净化护理专题 • 上一篇    下一篇

血液透析安全注射临床实践专家共识

中华护理学会血液净化专业委员会, 上海市护理学会血液净化专业委员会, (执笔:陈静 向晶 接艳青 吴霞珺 章海芬 黄碧红 杨振华 梁新蕊 曹立云 夏京华)()   

  1. 200003 上海市 海军军医大学第二附属医院肾脏病科(陈静,接艳青);解放军总医院第一医学中心肾脏科(向晶);上海交通大学医学院附属瑞金医院血液净化中心(吴霞珺,杨振华);上海交通大学医学院附属仁济医院血液净化中心(章海芬);复旦大学附属华山医院血液净化中心(黄碧红);海军军医大学第一附属医院血液净化中心(梁新蕊);北京大学第一医院肾内科血液净化中心(曹立云);中国医学科学院北京协和医院肾内科血液净化中心(夏京华)
  • 收稿日期:2021-09-16 出版日期:2022-04-10 发布日期:2022-03-31
  • 通讯作者: 向晶,E-mail:xiangjing2012@163.com
  • 作者简介:陈静:女,本科,副主任护师,护士长,E-mail:chenjzrx@163.com

Expert consensus on clinical practice of injection safety in hemodialysis

Blood Purification Committee of Chinese Nursing Association, Blood Purification Committee of Shanghai Nursing Association, ((Writing Committee:CHEN Jing, XIANG Jing, JIE Yanqing, WU Xiajun, ZHANG Haifen, HUANG Bihong, YANG Zhenhua, LIANG Xinrui, CAO Liyun, XIA Jinghua))()   

  • Received:2021-09-16 Online:2022-04-10 Published:2022-03-31

摘要:

目的 制订血液透析安全注射临床实践专家共识(以下简称《共识》),落实血液透析安全注射的规范化临床实践,确保血液透析患者治疗安全。方法 查阅国内外相关文献,结合临床护理专家工作经验,以循证护理为依据,寻找最佳证据,通过3轮德尔菲专家咨询和专家论证,对各个条目进行调整、修改和完善并达成共识。结果 《共识》总结了9个方面的最新证据,包含血液透析治疗中环境管理规范、人员资质要求、注射器具要求、药品安全注射管理、消毒剂使用、血管通路护理操作、血标本安全采集、医疗废弃物处理以及职业安全防护。3轮咨询专家积极系数均为100%,专家权威系数均为0.928,3轮咨询重要性赋值均数为4.38、4.45、4.68,专家意见趋于一致。3轮咨询专家协调系数经检验后均具有显著性差异(P<0.05)。结论 《共识》具有一定的科学性,可为血液透析从业人员行血液透析治疗安全注射提供依据。

关键词: 血液透析, 安全注射, 临床实践, 专家共识, 护理

Abstract:

Objective The aim of this work is to establish the expert consensus(hereinafter referred to as“consensus”) on clinical practice of injection safety in hemodialysis,to standardize the clinical practice of injection safety in hemodialysis and ensure patient safety during hemodialysis treatments. Methods Reviewing relevant literature and evidence-based nursing,summarizing the clinical work experience of care,we seeked for the best clinical evidence of injection safety. The consensus was performed by adjusting,modifying and perfecting each entry through three-round Delphi expert consultations and discussions. Results The consensus summarizes the latest evidence in 9 aspects,including environmental,personnel,syringes,safe administration of drugs,safe use of disinfectants,nursing practices on vascular access,specimen collection,medical waste and occupational safety,which covered all the elements and links in the hemodialysis therapy. In the three-round Delphi expert consultation and discussion,the positive coefficients were all 100% and the expert authority coefficients were all 0.928. The importance assignments were 4.38,4.45 and 4.68,respectively. The experts reached a fair degree of agreement. There were significant differences in experts’ coordination coefficients in the 3 rounds(P<0.05). Conclusion The consensus shows certain scientific natrue,and it may provide evidence for injection safety in hemodialysis therapy in China.

Key words: Hemodialysis, Injection Safety, Clinical Practice, Expert Consensus, Nursing Care