静脉输液质量监测闭环追踪系统的构建及应用

doi:10.3761/j.issn.0254-1769.2023.23.002

摘要/Abstract

摘要：

目的构建静脉输液质量监测闭环追踪系统并探讨其应用效果。方法成立研究团队，开发静脉输液质量监测闭环追踪系统，包括医嘱开具与审核模块、药物配置模块、医嘱执行过程及统计分析模块。该系统于2021年11月在临床试运行，2022年1月正式应用，比较系统应用前（2021年1月—12月）与应用后（2022年1月—12月）输液相关不良事件的发生数量及红灯呼叫量，采用随机抽样的方法选取1个病区统计异常输液数量。结果系统应用前输液相关不良事件发生3例，应用后发生1例。随机抽取神经内科病房，系统应用前病区内平均月红灯呼叫数量为（5 120.25±775.82）次，应用后为（1 518.25±74.77）次，差异具有统计学意义（P<0.001）。所抽取病房内1个月的输液总量共5 184瓶，其中，滴速过快155次（2.99%），共775 min；滴速过慢207次（3.99%），共1 035 min；平均处理时间均为5 min。结论静脉输液质量监测闭环追踪系统可对输液全程进行追踪与记录，为护理闭环质量检查提供准确、客观的数据，有利于管理者及时发现输液过程中潜在的问题，规范护理操作，提高静脉输液用药安全。

关键词: 静脉输液, 信息系统, 护理, 患者安全

Abstract:

Objective To monitor the quality of intravenous infusions in a constructed closed-loop tracking system，and to discuss its application effect. Methods The information program is reinvested in a team for the closed-loop tracking system of the intravenous infusion. There are modules of processing medical orders，pharmacy preparations，execution procedures with the doctor’s orders，as well as the computing module. The system was put into clinical trial operation in November 2021 and officially applied in January 2022. Specifically，the number of infusion-related adverse events/red-light alert is recorded and compared before（January to December 2021） and after（January to December 2022） the application of the system. Random sampling method has been performed in a ward to investigate the amount of abnormal infusion for the comparison. Results It is shown that it occurred 3 times for the infusion-related adverse events before the operation of the system，and a time after that. In the neurological inpatients，we observe the amount of red-light alert as 5，120.25±775.82 before the system operation，and 1，518.25±74.77 after that. It is shown to decline by 70.35% on average with statistical significance on the total difference（P<0.001）. Monthly amount of infusion in the ward is 5，184 with 155 times of overfast（2.99%）for 775 minutes in total，and with 207 times of slow（3.99%） for 1，035 minutes in total. The average handling time per contact is 5 minutes. Conclusion The closed-loop tracking system for intravenous infusion quality monitoring can track and record the whole process of intravenous infusions. It is expected to provide accurate and objective data for closed-loop quality inspection on clinical nursing practice，which is conducive to nursing managers for any potential problems during infusion processing timely，to promote standardized nursing operations，and to further improve the safety of inpatients with intravenous infusion and medication.

Key words: Intravenous Infusion, Information System, Nursing Care, Inpatient Safety

李谷维, 骆金铠, 张杰, 毛文平, 郭潇潇, 刘雨安. 静脉输液质量监测闭环追踪系统的构建及应用[J]. 中华护理杂志, 2023, 58(23): 2829-2834.

LI Guwei, LUO Jinkai, ZHANG Jie, MAO Wenping, GUO Xiaoxiao, LIU Yu’an. Application of a closed-loop tracking system in the quality monitoring program for intravenous infusions[J]. Chinese Journal of Nursing, 2023, 58(23): 2829-2834.

图/表 4

图1 静脉输液追踪流程图

Figure 1 Flowchart for intravenous fluids tracking

图2 闭环管理图

Figure 2 Schematic diagram of the closed-loop management

表1 系统应用前后治疗量比较（$\bar{x}±s$）

Table 1 Comparison of treatment volume before and after the application of the system（$\bar{x}±s$）

表2 静脉输液滴速异常原因

Table 2 Causes of the abnormal drip velocity for intravenous infusions

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