广西壮族自治区急诊科护士对蛇伤患者护理知信行的现状调查

doi:10.3761/j.issn.0254-1769.2026.17.016

摘要/Abstract

摘要：

目的了解急诊科护士对蛇伤患者护理的知识、态度、行为现状，并分析其影响因素。方法采用便利抽样法，选取2025年2—5月广西壮族自治区327名急诊科护士作为调查对象，通过一般资料调查表和自行编制的急诊科护士对蛇伤患者护理的知信行问卷收集数据，采用单因素分析和广义线性模型分析探讨知信行问卷总分的影响因素。结果共回收有效问卷317份，有效问卷回收率为96.94%，急诊科护士对蛇伤患者护理知信行总分为148.00（136.00，161.00）分，及格率94.64%，优秀率52.68%。其中，知识、态度、行为维度得分分别为29.00（20.50，41.00）、60.00（59.00，60.00）、64.00（56.00，65.00）分。多因素分析结果显示，医院级别、医院是否配备抗蛇毒血清以及护士是否接受过蛇伤患者护理规范化培训是急诊科护士对蛇伤患者护理知信行总分的影响因素（P<0.05）。结论广西壮族自治区急诊科护士对蛇伤患者护理的态度积极，但知识、行为方面仍有待加强。医院管理者应加强急诊科护士对蛇伤患者护理的规范化培训，完善抗蛇毒血清配置，制订标准化护理流程和护理手册，提升急诊科护士蛇伤患者护理综合能力，保障患者生命安全。

关键词: 蛇伤, 急诊科, 护士, 知识, 态度, 行为, 影响因素分析

Abstract:

Objective To investigate the current status of knowledge，attitude，and practice（KAP） regarding the care of snakebite patients among emergency department nurses，and to analyze the influencing factors. Methods From February to May 2025，a total of 327 emergency department nurses in the Guangxi Zhuang Autonomous Region were recruited by convenience sampling. Data were collected using a general information questionnaire and a self-developed KAP questionnaire on snakebite patient care for emergency department nurses. Univariate analysis and generalized linear models were used to explore the factors influencing the total KAP score. Results A total of 317 valid questionnaires were collected，yielding an effective response rate of 96.94%. The median total KAP score was 148.00（136.00，161.00）points，with a pass rate of 94.64% and an excellence rate of 52.68%. The median scores for knowledge，attitude，and practice were 29.00（20.50，41.00）points，60.00（59.00，60.00） points，and 64.00（56.00，65.00） points，respectively. Multivariate analysis indicated that hospital level，availability of antivenom in the hospital，and whether nurses had received standardized training on snakebite patient care were independent influencing factors for the total KAP score（P<0.05）. Conclusion Emergency department nurses in Guangxi Zhuang Autonomous Region demonstrate a positive attitude toward the care of snakebite patients，but their knowledge and practice still need to be strengthened. Hospital administrators should enhance standardized training on snakebite care for emergency nurses，ensure adequate antivenom supply，and develop standardized nursing procedures and manuals，so as to improve the snakebite care competence of emergency nurses and ensure patient safety.

Key words: Snakebite, Emergency Department, Nursing Staff, Knowledge, Attitude, Practice, Root Cause Analysis

梁政, 黄翠青, 李彩英. 广西壮族自治区急诊科护士对蛇伤患者护理知信行的现状调查[J]. 中华护理杂志, 2026, 61(17): 2420-2426.

LIANG Zheng, HUANG Cuiqing, LI Caiying. Knowledge，attitudes，and practices of emergency department nurses in Guangxi Zhuang Autonomous Region regarding snakebite patient care：a cross-sectional study[J]. Chinese Journal of Nursing, 2026, 61(17): 2420-2426.

图/表 3

表1 急诊科护士的一般资料及对蛇伤患者护理知信行的单因素分析（n=317）

Table 1 General characteristics of emergency department nurses and univariate analysis of knowledge，attitude，and practice regarding the nursing care of snakebite patients（n=317）

表2 急诊科护士对蛇伤患者护理的知信行调查各维度得分排名后3位的条目（n=317）

Table 2 The bottom 3 entries in terms of scores for each dimension in the survey on emergency department nurses’ knowledge，attitude，and practice toward nursing care for snakebite patients（n=317）

表3 急诊科护士对蛇伤患者护理的知信行的多因素分析结果（n=317）

Table 3 Results of the multivariate analysis of knowledge，attitude，and practice among emergency department nurses in caring for snakebite patients （n=317）

参考文献 25

[1]	中华医学会急诊医学分会, 国家急诊质控中心, 中国医师协会急诊医师分会, 等. 中国蛇伤救治指南[J]. 中华急诊医学杂志, 2024, 33(7):891-906.
	Emergency Medicine Branch of Chinese Medical Association,National Emergency Quality Control Center, Emergency Physi-cians Branch of China Medical Doctor Association, et al. Guide to snake wound treatment in China[J]. Chin J Emerg Med, 2024, 33(7):891-906.
[2]	Wood D. Clinical risk factors associated with poor outcomes in snake envenoming:a narrative review[J]. Toxins, 2023, 15(12):675. DOI URL
[3]	Hao WJ, Lü CZ, Song XY, et al. Vulnerability factors of snake bite patients in China[J]. BMC Public Health, 2024,24(1):1704.
[4]	Xie N, Luo Q, Zhang W, et al. Comparative efficacy of three wound care approaches in alleviating swelling and pain asso-ciated with snakebite wounds in a Chinese hospital[J]. Int Emerg Nurs,2024, 74:101438. DOI URL
[5]	Margono F, Outwater AH, Lowery Wilson M, et al. Snakebite treatment in Tanzania:identifying gaps in community practices and hospital resources[J]. Int J Environ Res Public Health, 2022, 19(8):4701. DOI URL
[6]	郭菁, 钟龙辉, 漆敏娜, 等. 程序化急救护理路径对提高毒蛇咬伤患者抢救成功率的分析[J]. 黑龙江医药科学, 2023, 46(1):42-44.
	Guo J, Zhong LH, Qi MN, et al. Analysis of programmed emer-gency nursing pathway to improve the success rate of snake-bite rescue[J]. Heilongjiang Med Pharm, 2023, 46(1):42-44.
[7]	陈媛媛, 谢美玲, 刘皖娟, 等. 一体化护理模式在急诊蛇咬伤患者护理救治中的应用效果[J]. 中国急救复苏与灾害医学杂志, 2023, 18(7):946-948,953.
	Chen YY, Xie ML, Liu WJ, et al. Application effect of inte-grated nursing mode in emergency care of snakebite patients[J]. China J Emerg Resusc Disaster Med, 2023, 18(7):946-948,953.
[8]	Afroz A, Siddiquea BN, Shetty AN, et al. Assessing knowledge and awareness regarding snakebite and management of snake-bite envenoming in healthcare workers and the general popu-lation:a systematic review and meta-analysis[J]. PLoS Negl Trop Dis, 2023, 17(2):e0011048. DOI URL
[9]	Saeed AA, Gibreel OA, B Mousa A, et al. Knowledge and per-ceptions of snakes,snakebites and their management among health care workers in Sudan[J]. PLoS One, 2024, 19(9):e0302698. DOI URL
[10]	邓春红, 陶品月. 负压封闭引流技术在毒蛇咬伤患者创面治疗中的应用进展[J]. 中华急危重症护理杂志, 2023, 4(5):424-429.
	Deng CH, Tao PY. Research progress of vacuum sealing drai-nage technology in wound treatment of venomous snakebite patients[J]. Chin J Emerg Crit Care Nurs, 2023,4(5):424-429.
[11]	罗海燕, 刘鸣江, 谢松林, 等. 眼镜蛇咬伤致四肢深层溃疡患者行皮瓣修复的护理[J]. 中华护理杂志,2019, 54(8):1201-1204.
	Luo HY, Liu MJ, Xie SL, et al. Nursing care of patients with deep ulcer of extremities after cobra injury repaired with skin flaps[J]. Chin J Nurs, 2019, 54(8):1201-1204. DOI
[12]	田春营, 赵志慧, 周杰, 等. 护理人员卫生法律知信行现状及影响因素[J]. 护理研究, 2024, 38(17):3176-3180.
	Tian CY, Zhao ZH, Zhou J, et al. Status quo of knowledge,belief,and practice of health law among nursing staff and its influencing factors[J]. Chin Nurs Res, 2024, 38(17):3176-3180.
[13]	Di Nicola MR, Crevani M, Avella I, et al. A guide to the cli-nical management of vipera snakebite in Italy[J]. Toxins, 2024, 16(6):255. DOI URL
[14]	中国蛇伤救治专家共识专家组. 2018年中国蛇伤救治专家共识[J]. 中国急救医学, 2018, 38(12):1026-1034.
	Group of Expert Consensus on Snake Injury Treatment in China. Expert consensus on snake injury treatment in China in 2018[J]. Chin J Crit Care Med, 2018, 38(12):1026-1034.
[15]	吴太琴, 甘秀妮, 高燕, 等. 肠内营养再喂养综合征护理知信行问卷的编制及信效度检验[J]. 中华护理杂志, 2024, 59(7):835-841. DOI
	Wu TQ, Gan XN, Gao Y, et al. Development of a Nursing Knowledge-Attitude-Practice Assessment Questionnaire for the Investigation of Enteral Nutrition Refeeding Syndrome and the test of its reliability and validity[J]. Chin J Nurs, 2024, 59(7):835-841. DOI
[16]	Aga AM, Mulugeta D, Motuma A, et al. Health professionals’ knowledge,attitudes,and practices in snakebite management:a study from high-burden areas in the Afar Region,Ethiopia[J]. PLoS Negl Trop Dis, 2025, 19(11):e0013713. DOI URL
[17]	Hu YL, Lü CZ, Song XY, et al. Current status and influencing factors of snakebite diagnosis and treatment knowledge among medical staff in China:a cross-sectional study[J]. Int J Public Health, 2023, 68:1606601. DOI URL
[18]	Rae JD, Artus R, Hunstig F, et al. Snakebite knowledge among healthcare workers in Gabon:a health facility-based cross-sec-tional survey[J]. PLoS Negl Trop Dis, 2026, 20(3):e0013742.
[19]	陈凤致, 张继承, 刘备备, 等. 山东省二级和三级综合医院ICU护士腹内压监测管理及认知现状调查[J]. 中国中西医结合急救杂志,2023, 30(3):358-363. DOI URL
	Chen FZ, Zhang JC, Liu BB, et al. Investigation of current status of management and knowledge of intra-abdominal pres-sure monitoring among intensive care unit nurses in secon-dary and tertiary general hospitals in Shandong Province[J]. Chin J Integr Tradit West Med Intensive Crit Care, 2023, 30(3):358-363.
[20]	范晓波, 姜艳萍, 刘慧, 等. 山东省血液透析室护士对患者透析中运动的知信行现状调查[J]. 中华护理杂志, 2024, 59(24):2973-2979.
	Fan XB, Jiang YP, Liu H, et al. Survey on the current status of knowledge,attitude and practice on exercise in main-tenance hemodialysis patients by nurses in hemodialysis rooms of Shandong Province[J]. Chin J Nurs, 2024, 59(24):2973-2979.
[21]	王莉, 程宇晗, 施雁, 等. 2023年-2024年上海市二、三级医院改善护理服务行动实施现状分析[J]. 中国护理管理,2025, 25(7):1055-1061.
	Wang L, Cheng YH, Shi Y, et al. Analysis of the implemen-tation status of nursing service improvement in Shanghai secondary and tertiary hospitals(2023-2024)[J]. Chin Nurs Manag, 2025, 25(7):1055-1061.
[22]	da Silva Cunha MB, da Frota KC, de Azevedo Ponte KM, et al. Construction and validation of an educational booklet to provide care for snakebite victims[J]. Rev Gaucha Enferm, 2020, 41:e20190467.
[23]	Ameade EPK, Bonney I, Boateng ET. Health professionals’ ove-restimation of knowledge on snakebite management,a threat to the survival of snakebite victims:a cross-sectional study in Ghana[J]. PLoS Negl Trop Dis, 2021, 15(1):e0008756.
[24]	侯秀凤, 王思瑶, 边巴欧珠, 等.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 XF, Wang SY, Bian BOZ, et al. The survey of knowle-dge,attitude and practice of nurses of 62 hospitals in Tibet Autonomous Region on the use of peripheral venous indwel-ling needle[J]. Chin J Nurs, 2024, 59(20):2463-2471.
[25]	武作家, 王钰炜, 闫丹萍, 等. 促进卓越与反思学习在急诊科护士团队协作情境模拟培训中的应用[J]. 中华护理杂志, 2025, 60(19):2391-2396. DOI
	Wu ZJ, Wang YW, Yan DP, et al. Evaluation of implemen-tation effect of promoting excellence and reflective learning in simulated training of nurses’ team collaboration in emer-gency departments[J]. Chin J Nurs, 2025, 60(19):2391-2396.