江苏省骨科护士对静脉血栓栓塞症机械预防的认知及应用情况调查  

A multicenter survey on cognition and clinical application of mechanical prevention of venous thromboembolism among orthopedic nurses in Jiangsu Province

作　　者：童亚慧 朱红霞[1] 邹叶芳[1] 徐岚[1] TONG Yahui;ZHU Hongxia;ZOU Yefang;XU Lan(The First Affiliated Hospital of Soochow University,Suzhou Jiangsu 215000)

机构地区：[1]苏州大学附属第一医院,江苏苏州215000

出　　处：《天津护理》2023年第1期27-31,共5页Tianjin Journal of Nursing

摘　　要：目的:调查江苏省骨科护士对静脉血栓栓塞症机械预防的认知现况及应用情况,为相应对策的制定提供依据。方法:采用自行设计的问卷以网络形式对江苏省13个市155所医疗机构共1693名骨科护士进行调查。结果:1693名骨科护士静脉血栓栓塞症机械预防认知得分为(97.6±28.2)分,总体水平较好。不同等级医院、职称、能力层级、专科工作年限、职务、有无机械预防操作经验和是否曾获得相关知识的骨科护士静脉血栓栓塞症机械预防认知水平得分差异有统计学意义(P<0.05)。机械预防措施临床应用方面,93.5%的医疗机构配备了机械预防相关设备且制定了静脉血栓栓塞症(VTE)防治以及机械预防装置操作流程,但其流程均为各医疗机构或科室制定。目前机械预防实施人群主要为下肢骨折、髋膝关节置换、脊柱疾患、多发伤、肿瘤患者等,以前两者居多(占80.7%和78.0%)。81.9%的医疗机构采用Caprini评估量表作为VTE风险评估工具。骨科护士实施机械预防措施的主要临床依据为进行VTE风险评估后提醒医生,占67.4%。各医疗机构在机械装置使用时长和频率方面仍存在很大差异,尚缺乏统一操作标准。临床仍存在VTE风险患者未落实机械预防的状况,且发生率达到89.9%。其中最主要的原因为患者不愿接受,占71.8%。结论:江苏省骨科护士对静脉血栓栓塞症机械预防认知总体水平较好,但二级医院和一级医院相对较低,因此仍需加强培训。各医疗单位机械预防装置缺乏统一操作标准,需加快机械预防装置操作流程统一标准的制定。机械预防实施过程中仍存在患者不依从现象,需进一步进行依从性相关研究,并提出相应的护理对策。Objective:To investigate the status of cognition and clinical application of mechanical prevention measures of venous thromboembolism among orthopedic nurses,so as to provide basis for proposing corresponding countermeasures in the future.Methods:A self-made questionnaire was used to investigate 1693 orthopedic nurses in 155 medical units from13 cities of Jiangsu Province.Results:The average score of cognition related to mechanical prevention of venous throm-boembolism among 1693 orthopedic nurses was 97.6±28.2,and the overall level was good.There were significant differences in the scores of cognition of mechanical prevention among orthopedic nurses with different levels of hospitals,profes-sional titles,ability levels,working years in specialty,positions,experience in mechanical prevention operation and knowl-edge(P<0.05).In terms of clinical application of mechanical preventive measures,93.5%of medical institutions were e-quipped with mechanical preventive equipment,and VTE prevention and operation process of mechanical preventive de-vices were formulated.At present,mechanical prevention is mainly implemented in patients with lower limb fractures,hip and knee replacement,spinal diseases,multiple injuries,tumor,etc.,while the former two accounted for 80.7%and 78.0%.81.9%of medical institutions used caprini assessment scale as a risk assessment tool for venous thromboembolism(VTE).The main clinical basis for orthopedic nurses to implement mechanical preventive measures was to remind doctors after VTE risk assessment,accounting for 67.4%.There were great differences in the using time and frequency of mechanical devices in various medical units,and there was still a lack of unified operating standards.The incidence rate of patients with VTE risk who had not been implemented mechanical prevention was 89.9%.The main reason was that the patients were unwilling to accept it,which reached 71.8%.Conclusion:The overall level of orthopedic nurses’cognition of mechanical prevention of venous thromboembolism was good,but

关 键 词：骨科护士 静脉血栓栓塞症 机械预防 临床应用 调查 

分 类 号：R473.6[医药卫生—护理学]