62所西藏自治区医院护士对外周静脉留置针置入及维护的知信行现状调查

doi:10.3761/j.issn.0254-1769.2024.20.005

摘要/Abstract

摘要：

目的调查西藏自治区医院护士对外周静脉留置针置入及维护的认知、态度、实践行为现状，并分析相关影响因素。方法采用方便抽样法，于2023年11月—12月选取西藏自治区7个地级市（地区）62所医院的护士作为调查对象，采用自制调查问卷，以电子问卷的形式进行调查。采用单因素分析、多元线性回归分析，探究护士对外周静脉留置针置入及维护的认知、态度、实践行为的影响因素。结果共回收1 320份问卷，其中有效问卷1 319份，有效问卷回收率为99.92%。护士对外周静脉留置针置入及维护的认知、态度、实践行为维度得分依次为（46.24±13.68）（79.75±10.30）（60.38±14.15）分。808名（61.26%）护士接受过相关培训。多元线性回归分析结果显示，有无相关培训经历、民族、学历、职称、工作科室及医院所在地区是认知维度得分的影响因素（P<0.05）；有无相关培训经历、民族、学历、职称、医院所在地区是态度维度得分的影响因素（P<0.05）；有无相关培训经历、民族、学历、工作科室及医院所在地区是实践行为维度得分的影响因素（P<0.05）。结论西藏自治区医院护士对外周静脉留置针置入及维护的认知水平亟需提高、态度较好、实践行为有待规范。护理管理者应根据相关影响因素对护士实施针对性的培训，丰富培训形式和内容，以满足护士的需求，从而提升西藏自治区的静脉治疗质量。

关键词: 外周静脉留置针, 护士, 知信行, 影响因素分析, 护理

Abstract:

Objective To investigate the knowledge，attitude and practice of nurses from hospitals in Tibet Autonomous Region on the use of peripheral venous needle and analyze the influencing factors. Methods Utilizing a convenience sampling approach，we conducted a survey from November to December 2023 involving 1 319 nurses from 62 hospitals across 7 cities（regions） of Tibet Autonomous Region. Custom-made electronic questionnaires were utilized. Results A total of 1 320 questionnaires were collected，of which 1 319 were valid，with an effective response rate of 99.92%. The scores of nurses’ knowledge，attitude and practice were 46.24±13.68，79.75±10.30，and 60.38±14.15，respectively. 808（61.26%） nurses had received relevant training experience. The results of multiple linear regression analysis showed that the influencing factors of nurses’ knowledge of peripheral venous indwelling needle included whether they had received training experience，ethnicity，education background，professional title，department and hospital region（P<0.05）. Training experience，ethnicity，educational background，profession title and hospital region were the influence factors of nurses’ attitude of venous indwelling needle（P<0.05）. Whether they had received training，ethnicity，education background，department and hospital region were the influencing factors of nurses’ practice of peripheral venous indwelling needle（P<0.05）. Conclusion Nurses from hospitals in Tibet Autonomous Region have a good attitude towards using venous indwelling needle. However，the knowledge level is not ideal and the practice is still needed to be improved. Nursing managers should implement targeted training and enrich the training form and content，so as to meet the needs of nurses and to improve the quality of intravenous therapy in the Tibet Autonomous Region.

Key words: Peripheral Venous Indwelling Needle, Nurse, Knowledge，Attitude and Practice, Root Cause Analysis, Nursing Care

侯秀凤, 王思瑶, 边巴欧珠, 嘎多, 德吉, 王柳, 色吉那. 62所西藏自治区医院护士对外周静脉留置针置入及维护的知信行现状调查[J]. 中华护理杂志, 2024, 59(20): 2463-2471.

HOU Xiufeng, WANG Siyao, Bianbaouzhu, Gaduo, Deji, WANG Liu, Sejina. The survey of knowledge，attitude and practice of nurses of 62 hospitals in Tibet Autonomous Region on the use of peripheral venous indwelling needle[J]. Chinese Journal of Nursing, 2024, 59(20): 2463-2471.

图/表 5

表1 西藏自治区护士对留置针置入及维护认知维度正确率、态度和实践行为维度得分前3位和后3位的条目

Table 1 The top 3 and the bottom 3 item scores of nurses in hospitals of the Tibet Autonomous Region on the accuracy rate of knowledge, attitude and practice on implantation and maintenance of peripheral venous catheter

表2 西藏自治区医院护士对留置针置入及维护的认知、态度、实践行为影响因素的单因素分析结果（n=1 319，分，$\bar{x}\pm s$）

Table 2 Single factor analysis results of influencing factors of knowledge, attitude and practice of nurses in hospitals of Tibet Autonomous Region on peripheral venous catheter（n=1 319，score，$\bar{x}\pm s$）

表3 自变量赋值方式

Table 3 Assignment for categorical variables

表4 西藏自治区医院护士对留置针置入及维护的认知、态度、实践行为影响因素的多元线性回归分析结果（n=1 319）

Table 4 Linear regression analysis of knowledge，attitude，and practice of nurses in hospitals of Tibet Autonomous Region peripheral venous catheter （n=1 319）

表5 西藏自治区医院护士对留置针置入及维护培训内容、途径的需求调查结果（n=1 319）

Table 5 The demands of training content and approach of peripheral venous catheter for nurses in hospitals of Tibet Autonomous Region（n=1 319）

参考文献 22

[1]	王蕾, 聂圣肖, 孙红. 743家二级和三级医院静脉治疗现状的调查研究[J]. 中华现代护理杂志, 2020, 26(32):4494-4500.
	Wang L, Nie SX, Sun H. Current status of infusion therapy in 743 Class Ⅱ and Class Ⅲ hospitals[J]. Chin J Mod Nurs, 2020, 26(32):4494-4500.
[2]	Marsh N, Webster J, Ullman AJ, et al. Peripheral intravenous catheter non-infectious complications in adults:a systematic review and meta-analysis[J]. J Adv Nurs, 2020, 76(12):3346-3362.
[3]	Marsh N, Larsen EN, Ullman AJ, et al. Peripheral intravenous catheter infection and failure:a systematic review and meta-analysis[J]. Int J Nurs Stud, 2024,151:104673.
[4]	李谷维, 骆金铠, 张杰, 等. 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. DOI
	Li GW, Luo JK, Zhang J, et al. Application of a closed-loop tracking system in the quality monitoring program for intravenous infusions[J]. Chin J Nurs, 2023, 58(23):2829-2834. DOI
[5]	凤春燕, 周艳, 江萍, 等. 敏感指标在住院患者输液质量安全管理中的效果[J]. 河南大学学报(医学版), 2024, 43(1):75-78.
	Feng CY, Zhou Y, Jiang P, et al. Effect analysis of sensitive indexes in infusion quality and safety management of inpatients[J]. J Henan Univ(Med Sci), 2024, 43(1):75-78.
[6]	吴旭红, 段明霞, 王璐, 等. 儿科护士静脉输液治疗知识掌握情况的调查研究[J]. 中华现代护理杂志, 2020, 26(1):26-31.
	Wu XH, Duan MX, Wang L, et al. Investigation on the knowledge of pediatric nurses about intravenous infusion therapy[J]. Chin J Mod Nurs, 2020, 26(1):26-31.
[7]	Gorski LA, Hadaway L, Hagle ME, et al. Infusion therapy standards of practice,8th edition[J]. J Infus Nurs, 2021, 44(Suppl 1):S1-S224.
[8]	国家卫生健康委员会. 静脉治疗护理技术操作标准WS/T 433-2023[S/OL]. (2023-08-29)[2024-08-01]. http://www.nhc.gov.cn/wjw/pjl/202309/596da87e29c24708b531ca226485cdf2/files/6377cea1a74f45b3ae5af0eff974cf25.pdf.
	National Health and Family Planning Commission. Nursing practice standard for intravenous therapy WS/T 433-2023[S/OL]. (2023-08-29)[2024-08-01]. http://www.nhc.gov.cn/wjw/pjl/202309/596da87e29c24708b531ca226485cdf2/files/6377cea1a74f45b3ae5af0eff974cf25.pdf.
[9]	中华护理学会医院感染管理专业委员会, 中华护理学会静脉治疗专业委员会. 输液连接装置安全管理专家共识[J]. 中华护理杂志, 2022, 57(23):2821-2824. DOI
	Hospital Infection Management Committee of Chinese Nursing Association,Intravenous Therapy Committee of Chinese Nursing Association. Expert consensus on safety management of transfusion connection devices for vascular access[J]. Chin J Nurs, 2022, 57(23):2821-2824. DOI
[10]	韩柳, 杨宏艳, 刘飞, 等. 无针输液接头临床应用的最佳证据总结[J]. 中华护理杂志, 2020, 55(8):1239-1246. DOI
	Han L, Yang HY, Liu F, et al. Evidence summary for clinical application of needle-free infusion connector[J]. Chin J Nurs, 2020, 55(8):1239-1246. DOI
[11]	虞露艳, 应燕, 王秋月, 等. 小儿外周静脉导管敷贴固定和更换的最佳证据应用[J]. 中华护理杂志, 2019, 54(3):356-362. DOI
	Yu LY, Ying Y, Wang QY, et al. Application of the best evidence for peripheral venous catheter dressing fixation and replacement in pediatric patients[J]. Chin J Nurs, 2019, 54(3):356-362. DOI
[12]	Maki DG, Kluger DM, Crnich CJ. The risk of bloodstream infection in adults with different intravascular devices:a systematic review of 200 published prospective studies[J]. Mayo Clin Proc, 2006, 81(9):1159-1171.
[13]	王秋丽, 王秀丽, 侯铭. 临床护士对外周静脉留置针知识、态度、行为调查及其影响因素分析[J]. 护理实践与研究, 2021, 18(22):3342-3346.
	Wang QL, Wang XL, Hou M. Investigation of clinical nurses’ knowledge,attitude and practice of peripheral intravenous indwelling needles and analysis of their influencing factors[J]. Nnrsing Prac Res, 2021, 18(22):3342-3346.
[14]	陶艳玲. 新入职护士外周静脉留置针知识、态度、行为、技能调查分析[D]. 广州: 南方医科大学, 2014.
	Tao YL. Investigation and analysis on knowledge,attitude,behavior and skills of peripheral vein indwelling needle among new nurses[D]. Guangzhou: Southern Medical University, 2014.
[15]	陈小莉, 黄雅萱, 洪燕梅, 等. 线上线下混合式培训者培训模式在基层医院低年资护士静脉导管维护的应用效果[J]. 福建医药杂志, 2023, 45(3):144-147.
	Chen XL, Huang YX, Hong YM, et al. Application effect of online and offline mixed trainer training mode in maintenance of venous catheter for junior nurses in primary hospitals[J]. Fujian Med J, 2023, 45(3):144-147.
[16]	刘俊兰, 李贞. 静脉留置针在临床护理中的应用[J]. 全科护理, 2021, 19(11):1489-1491.
	Liu JL, Li Z. Application of venous indwelling needle in clinical nursing[J]. Chin Gen Pract Nurs, 2021, 19(11):1489-1491.
[17]	Kwekkeboom KL. Overview and tips for successful grant writing for infusion nurses[J]. J Infus Nurs, 2014, 37(5):371-378. DOI PMID
[18]	王辰, 刘常清, 万莉, 等. 我国静脉治疗的研究进展[J]. 中华现代护理杂志, 2022, 28(23):3207-3215.
	Wang C, Liu CQ, Wan L, et al. Research progress of infusion therapy in China[J]. Chin J Mod Nurs, 2022, 28(23):3207-3215.
[19]	廖巧聪, 罗秀娟, 詹华玉, 等. 沉浸式教学在军队护士静脉输液技术培训中的应用[J]. 卫生职业教育, 2023, 41(22):107-109.
	Liao QC, Luo XJ, Zhan HY, et al. Application of immersive teaching in the technical training of intravenous infusion for military nurses[J]. Health Vocat Educ, 2023, 41(22):107-109.
[20]	刘柳, 黄新. 基于团队学习教学方法在临床护士静脉治疗护理安全培训中的应用[J]. 中华医学教育杂志, 2020, 40(1):51-55.
	Liu L, Huang X. Application of team-based learning in the safety training of clinical nurses in intravenous therapy[J]. Chin J Med Educ, 2020, 40(1):51-55.
[21]	吴欣娟, 丁炎明, 郑一宁. 我国30家三级甲等医院2019年:2020年《静脉治疗护理技术操作规范》实施现状调查[J]. 中国护理管理, 2022, 22(9):1281-1284.
	Wu XJ, Ding YM, Zheng YN. Status survey of the implementation of Nursing Practice Standards for Intravenous Therapy in 30 tertiary grade A hospitals in China from 2019 to 2020[J]. Chin Nurs Manag, 2022, 22(9):1281-1284.
[22]	霍晓鹏, 张红梅, 赖小星, 等. 专科护士多层次复合型管理方案的构建与实践[J]. 中华护理杂志, 2024, 59(7):842-847. DOI
	Huo XP, Zhang HM, Lai XX, et al. Construction and practice of multilevel and inter-disciplinary management scheme for specialist nurses[J]. Chin J Nurs, 2024, 59(7):842-847. DOI