1 926所医院静脉治疗质量管理现状的调查研究

doi:10.3761/j.issn.0254-1769.2024.20.003

摘要/Abstract

摘要：

目的调查国内二级和三级医院静脉治疗质量管理现状，为制订相关对策，推动静脉治疗向专业化、规范化、同质化方向发展提供参考。方法采用便利抽样法，于2023年11月选取31个省（区、市）二级和三级医院的静脉治疗护理管理者作为调查对象，使用自行设计的调查问卷进行调查。结果共回收2 129份问卷，其中有效问卷1 926份，有效问卷回收率为90.47%。1 926所医院中，1 733所（89.98%）医院制订了静脉治疗质量评价标准，1 734所（90.03%）医院定期组织静脉治疗或PICC留置与维护质量检查，1 604所（83.28%）医院建立了静脉治疗或PICC相关并发症处理与上报制度；1 574所（81.72%）医院定期收集、分析静脉治疗或PICC留置及维护相关数据，371所（19.26%）医院建立了静脉治疗信息管理系统。针对静脉治疗相关文书，制订各类导管置管知情同意书的比例最高，均>80.00%；其次为置管记录单、导管维护记录单；制订并发症处理记录单的比例最低，均<50.00%。针对静脉治疗相关流程，制订各类导管维护流程的比例最高，均>85.00%，其次为置管流程；除PICC外，针对其他导管制订拔管流程和并发症处理流程的比例较低，均<65%。在静脉治疗质量管理方面，二级、三级医院比较，存在较大差异。结论静脉治疗质量评价标准较完善，但信息化建设较薄弱，相关文书和流程有待进一步规范，且不同等级医院的静脉治疗管理水平存在差异。

关键词: 静脉治疗, 质量管理, 横断面研究, 护理管理研究

Abstract:

Objective To investigate the current state of quality management on intravenous therapy in secondary and tertiary hospitals in China. This study aims to provide a reference for the development of relevant policies，promoting the professionalization，standardization，and homogenization of intravenous therapy. Methods By a convenience sampling method，intravenous therapy nursing managers from secondary and tertiary hospitals in 31 provinces，autonomous regions，and municipalities were selected as survey participants in November 2023. A self-designed questionnaire was used for the survey. Results A total of 2 129 questionnaires were collected，of which 1，926 were valid，resulting in a response rate of 90.47%. Among the 1 926 hospitals，1 733（89.98%） had established quality evaluation standards for intravenous therapy，and 1 734（90.03%） conducted regular quality inspections for intravenous therapy or peripherally inserted central catheter（PICC） insertion and maintenance. Additionally，1 604 hospitals（83.28%） had established protocols for handling and reporting intravenous therapy or PICC-related complications，and 1 574 hospitals（81.72%） regularly collected and analyzed data related to intravenous therapy or PICC insertion and maintenance. Moreover，371 hospitals（19.26%） had implemented intravenous therapy information management systems. Regarding various types of intravenous therapy documents，the highest rate of document types was informed consent forms，with a compliance rate of over 80.00%，followed by insertion records and catheter maintenance records，respectively. The lowest rate was complication management records，with a compliance rate of less than 50.00%. For catheter maintenance protocols，the highest compliance rate was for maintenance procedures，at over 85.00%，followed by insertion procedures. Except for PICCs，the compliance rate for establishing catheter removal and complication management procedures for other types of catheters was less than 65.00%. In terms of quality management of intravenous therapy，there are significant differences between secondary and tertiary hospitals. Conclusion The quality evaluation standards for intravenous therapy are relatively comprehensive，but the informatization of intravenous therapy quality management is still underdeveloped. Furthermore，there is a need to further standardize the documentation and procedures related to intravenous therapy，and there are differences in the level of intravenous therapy management among hospitals of different levels.

Key words: Intravenous Therapy, Quality Management, Cross-Sectional Studies, Nursing Administration Research

董方方, 王蕾, 高伟, 耿敬芝, 孙文彦, 王宇, 杨巧芳, 宋圆圆, 李春燕. 1 926所医院静脉治疗质量管理现状的调查研究[J]. 中华护理杂志, 2024, 59(20): 2447-2454.

DONG Fangfang, WANG Lei, GAO Wei, GENG Jingzhi, SUN Wenyan, WANG Yu, YANG Qiaofang, SONG Yuanyuan, LI Chunyan. Investigation on the quality management of intravenous therapy in 1 926 hospitals[J]. Chinese Journal of Nursing, 2024, 59(20): 2447-2454.

图/表 5

表1 医院所属区域的分布情况（n=1 926）

Table 1 The distribution of hospitals in different regions（n=1 926）

表2 不同等级医院静脉治疗质量管理标准的制订及实施情况比较（n=1 926）

Table 2 Development of quality standards for intravenous therapy in hospitals of different levels（n=1 926）

表3 不同等级医院静脉治疗信息管理情况比较（n=1 926）

Table 3 Intravenous therapy information management systems in hospitals of different levels（n=1 926）

表4 不同等级医院静脉治疗相关文书的制订情况比较[所（百分比，%）]

Table 4 Comparison of the formulation of intravenous therapy related documents in hospitals of different levels[cases（percentage，%）]

表5 不同等级医院静脉治疗相关流程的制订情况比较[所（百分比，%）]

Table 5 Comparison of the formulation of catheter-related work processes in hospitals of different levels [cases（percentage，%）]

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