临床护士输注血管活性药物的现状调查

doi:10.3761/j.issn.0254-1769.2021.08.014

摘要/Abstract

摘要：

目的调查护士输注血管活性药物的现状,比较不同等级、性质医院之间的差异。方法采用便利抽样法,于2020年7月—8月对来自31个省份的护士进行在线调查。调查内容包括护士的一般资料、血管活性药物使用现状、血管通路的使用现状和输注血管活性药物的护理实践。结果共回收7 873份有效试卷。留置针（93.92%）是护士常用的血管通路,其次是中心静脉导管（61.27%）,钢针（15.11%）使用最少。与非三级医院、综合医院相比,三级医院和心血管专科医院的护士使用中心静脉导管的比例较高,差异具有统计学意义（P<0.001）。血压、心率和呼吸频率是护士常评估与观察的3项指标。与三级医院相比,非三级医院的护士在输注血管活性药物时不更换输注部位、采用可调速输液器/手动调节速度、认为变动注射泵的高低位置不影响输注血管活性药物的稳定性、封管前未回抽剩余药液、按快速输液键或使用生理盐水加速推进的方式处理回血、未对所有患者进行心电监护方面的比例较高,差异具有统计学意义（P<0.05）。与心血管专科医院相比,综合医院的护士在输注血管活性药物时在三通接头处快速推注其他药物、封管前未回抽剩余药液、按快速输液键或使用生理盐水加速推进的方式处理回血、未对所有患者进行心电监护方面的比例较高,差异具有统计学意义（P<0.001）。结论临床护士输注血管活性药物的护理实践存在安全隐患,有必要制订血管活性药物静脉输注护理标准,并对其进行规范化管理与监督。

关键词: 心血管药物, 血管通路, 护士, 护理管理研究

Abstract:

Objective To investigate the current status of infusion of vasoactive agents of Chinese nurses and compare the differences between different hospitals. Methods Convenience sampling method was used to conduct a descriptive online survey in 31 provinces from July to August,2020. The contents of the survey include demographic characteristics,current application of vasoactive agents,the use of vascular access and nursing practice of vasoactive agent infusion. Results A total of 7 873 qualified samples were collected. Indwelling needles（93.92%）were the most common vascular access for vasoactive agent,followed by central venous catheters（61.27%）,and steel needles accounted for the least（15.11%）. The proportion of nurses in tertiary hospitals or cardiovascular specialist hospitals using central venous catheters was relatively higher than that in non-tertiary hospitals or general hospitals（P<0.001）. Blood pressure,heart rate and respiration rate were 3 commonly used indicators for both evaluation and observation. Compared with the nurses in tertiary hospitals,there is a relatively higher proportion of nurses in non-tertiary hospitals who do not change the infusion site,use adjustable infusion apparatus or manual speed control,think that changing the height of syringe pumps does not affect the stability of the infusion,do not pump back before locking,press quick infusion key or make a rapid injection of normal saline when the blood returns,and do not perform ECG monitoring for all patients when infusing vasoactive agents（P<0.05）. Meanwhile,there is a higher proportion of nurses in general hospitals who inject other agents fleetly through T-pipe,do not pump back before locking,press quick infusion key or rapid inject normal saline when blood returns and do not perform ECG monitoring for all patients when infusing vasoactive agents,compared with nurses in cardiovascular specialist hospitals（P<0.001）. Conclusion The nursing practice of infusing vasoactive agents has safety risks. Thus,the nursing standards for intravenous infusion of vasoactive agents need to be revised,and nurse managers are advised to conduct standardized management and supervision.

Key words: Cardiovascular Agents, Vascular Access, Nurses, Nursing Administration Research

钟竹青,秦宁,高学琴,康晓凤,丁四清,刘亚平,李庆印. 临床护士输注血管活性药物的现状调查[J]. 中华护理杂志, 2021, 56(8): 1208-1215.

ZHONG Zhuqing,QIN Ning,GAO Xueqin,KANG Xiaofeng,DING Siqing,LIU Yaping,LI Qingyin. Current status of infusion of vasoactive agents of nurses：a nationwide survey[J]. Chinese Journal of Nursing, 2021, 56(8): 1208-1215.

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