术后镇痛和抗栓治疗患者的护理安全管理  

Safety management for patients receiving epidural analgesia or low molecular weight heparin(LMWH) antithrombotic therapy

作　　者：童莺歌[1] 刘敏君[2] 李云霞[3] 胡佳瑛[3] 朱红芳[3] 田素明[2] 

机构地区：[1]杭州师范大学护理学院,浙江杭州310036 [2]浙江大学医学院附属邵逸夫医院麻醉科 [3]浙江大学医学院附属邵逸夫医院骨科

出　　处：《护理学杂志》2013年第8期4-7,共4页

基　　金：浙江省教育厅资助课题(Y201225205)

摘　　要：目的探讨术后接受硬膜外腔镇痛和低分子肝素防栓疗法患者的护理安全管理方法。方法根据美国区域麻醉和镇痛学会2010年指南,通过成立质量改进小组、分析存在问题、建立特定护理安全规程、开展护士培训与考核及加强学科间交流5个环节实施护理安全管理。结果实施护理安全管理后,硬膜外腔镇痛拔管时点的规范性和拔管后低分子肝素注射时点的规范性及护士对相关知识的掌握程度显著提高(均P<0.01)。结论根据循证指南实施护理安全管理,有助于规范护理实践,提高护士的知识及能力,促进护理安全。Objective To explore safety-enhancing measures for patients receiving epidural analgesia （EA） or low molecular weight heparin（LMWH） antithrombotic therapy. Methods According to 2010 guidelines of American Society of Regional Anesthesia and Pain Medieine（ASRA）, we formed a quality improvement group, analyzed current problems in caring for patients under EA or on LMWH antithrombotie therapy, formulated safety-enhancing policies and measures, provided training program for nurses and in tensified assessment, and enhanced interdisciplinary communication. Results After safety management, the rate of epidural catheter removal at ideal time, and rate of post-catheter-removal LMWH administration at ideal time, were significantly improved（P-C0.01 for all） ; nurses＇ knowledge of EA and LMWH antithrombotic therapy was also significantly enhaneed（P〈0.01）. Conclusion lm plementation of nursing safety management according to evidence based guidelines improves standardization of nursing practice and nurses＇ knowledge, therefore enhances patients＇ safety.

关 键 词：硬膜外镇痛 防栓疗法 硬膜外腔血肿 护理安全 安全管理 

分 类 号：R47[医药卫生—护理学] R197.323[医药卫生—临床医学]