降低留置针药物外渗的循证护理实践  

Evidence-based nursing practice and evaluation of effects for reducing extravasation of peripheral venous catheters

作　　者：杨洪华[1] 刘万里[1] 贺连香[1] 孙士昌[1] 唐云红[1] 匡雪春[1] 陆敏敏[2] Yang Honghua;Liu Wanli;He Lianxiang;Sun Shichang;Tang Yunhong;Kang Xuechun;Lu Minmin(XiangYa Hospital of Central South University,Changsha Hunan 410008;School of Nursing,Fudan University,Shanghai 200032)

机构地区：[1]中南大学湘雅医院,湖南长沙410008 [2]复旦大学护理学院,上海200032

出　　处：《护士进修杂志》2020年第19期1734-1738,共5页Journal of Nurses Training

基　　金：复旦大学循证护理中心证据转化与临床应用项目(编号:Fudanebn201821);中南大学湘雅医院“双一流”课题项目(编号:SY-2018-4)。

摘　　要：目的通过应用基于循证的最佳护理实践减少留置针外渗的发生率。方法用循证护理的方法获取最佳实践证据,并使用澳大利亚JBI临床证据实践应用系统将证据应用于中南大学湘雅医院留置针外渗发生率高的病区,比较证据应用前后护士对降低留置针药物外渗知识的掌握情况、7条标准的审查结果以及留置针外渗的发生率。结果循证实践前后,护士留置针外渗知识问卷平均得分由(29.38±10.20)分提高至(40.63±6.22)分,差异有统计学意义(P<0.05);7条指标在证据应用后达标率均有提高,除指标2,其它6项指标证据应用前后比较差异均有统计学意义(P<0.05)。药物外渗发生率从13.56%降至6.49%,差异有统计学意义(P<0.01)。结论通过循证实践,可以规范护士对留置针输注腐蚀性药物的管理行为,有效降低药物外渗的发生率。Objective To study the interventions based on best evidence for reducing extravasation of peripheral venous catheters.Methods The best evidence-based interventions were obtained by adopting evidence-based nursing procedures and were implemented in a high extravasation incidence ward of a Third-grade class A hospital.This project was guided by the Joanna Briggs Institute(JBI)practice application of clinical evidence system(PACES).The knowledge of nurses and the extravasation rates of peripheral venous catheters before and after the implementation were compared.Results After implementation of the evidence-based interventions,the average score of questionnaire was increased by(29.38±10.20)to(40.63±6.22).There was significant difference(P<0.01).The extravasation rate of peripheral venous catheters was decreased from 13.56%to 6.49%.The difference was statistically significant(P<0.01).Conclusion The evidence-based nursing interventions can further standardize the usage of peripheral venous catheters,and effectively reduce the rates of extravasation of peripheral venous catheters.

关 键 词：留置针 腐蚀性药物 外渗 循证实践 循证护理 

分 类 号：R472.9[医药卫生—护理学]