Abstract:

Objective To investigate the status of insulin injection management in hospitals at all levels in 31 provinces and autonomous regions,so as to provide references for promoting standardized and homogenized management of insulin injection in hospitals. Methods Nursing managers in 1 075 hospitals in 31 provinces,municipalities and autonomous regions were surveyed by stratified random cluster sampling from January to February 2019 with a self-designed questionnaire. Results A total of 1 075 valid questionnaires for nursing managers from nursing departments,and 1 5794 valid questionnaires for nursing managers from clinical departments were collected. 976（90.79%） surveyed hospitals manage insulin as a high-risk drug. More than 80% surveyed hospitals formulated insulin injection specifications at the hospital level or department level,provided regular training and assessment,and organized insulin injection training for new nurses. 828 hospitals（77.02%） regularly carried out insulin management quality control. More than 80% of the departments are equipped with multiple types of cardinal insulin and placed in special places,stored insulin in use in special places,stored opened insulin at room temperature. 90.53% of the doctors in the department prescribed injection orders for patients with self-provided insulin;insulin management institution and insulin management status of departments in different levels of hospitals,and insulin management status in different departments showed statistically significant differences （P<0.001）. Insulin management was more standardized in hospitals with regular quality control of insulin management（P<0.001）. Conclusion Insulin management institution in hospitals at different levels in China needs to be improved,and the quality of insulin management in departments needs to be improved. Insulin management in different hospitals and departments needs to be homogenized. It is necessary to strengthen the insulin injection management in primary hospitals and non-endocrinology departments. Relevant academic organizations should issue the standard of insulin injection management in hospital to promote the standardized management of insulin injection in hospitals.

Key words: Diabetes Mellitus, Insulin, Injections, Hospital, Nursing Administration Research

摘要：

目的 调查31个省份各级医院胰岛素注射院内管理现状,为促进院内胰岛素注射规范化、同质化管理提供参考依据。 方法 采用分层随机整群抽样法,于2019年1月—2月采用自行设计的问卷对31个省、市、自治区1 075所医院的护理部及科室护理管理者进行调查。 结果 共收回护理部护理管理者有效问卷1 075份,科室护理管理者有效问卷15 794份。976所（90.79%）被调查医院将胰岛素作为高危药品管理;80%以上的医院由全院或科室制订胰岛素注射操作规范、定期培训与考核、组织新护士胰岛素注射操作培训;828所（77.02%）医院定期进行胰岛素管理质量控制;80%以上的科室专区多规存放基数胰岛素,专区存放患者正在使用中的胰岛素,胰岛素开封后常温保存;90.53%的科室医生为自备胰岛素的患者开具注射医嘱;不同等级医院胰岛素管理制度、科室胰岛素管理比较,不同科室胰岛素管理现状比较,差异均具有统计学意义（P<0.001）;定期进行胰岛素管理质量控制的医院,科室胰岛素管理更规范（P<0.001）。 结论 各级医院胰岛素相关管理制度有待完善,科室胰岛素管理质量有待改善。不同等级医院、不同科室胰岛素管理有待同质化。需要加强基层医院、非内分泌科胰岛素注射管理。相关学术组织应出台胰岛素注射院内管理标准,推动院内胰岛素注射规范化管理。

关键词: 糖尿病, 胰岛素, 注射, 医院, 护理管理研究