肿瘤静脉化疗安全用药规范的构建  

Construction of safe medication standard for cancer intravenous chemotherapy

作　　者：唐清 姚丹 王国蓉[3] 蒋倩[4] 罗蕾[3] 姚文秀[5] 张甜 周红艳[6] TANG Qing;YAO Dan;WANG Guorong;JIANG Qian;LUO Lei;YAO Wenxiu;ZHANG Tian;ZHOU Hongyan(Department of Nursing,Medical College of University of Electronic Science and Technology,Chengdu,610054,China)

机构地区：[1]电子科技大学医学院护理系,成都市610054 [2]成都中医药大学护理学院 [3]四川省肿瘤医院护理部 [4]四川省肿瘤医院临床药学部 [5]四川省肿瘤医院肿瘤内科 [6]四川省肿瘤医院科技部

出　　处：《中国护理管理》2024年第1期62-68,共7页Chinese Nursing Management

基　　金：四川省科技厅重点研发项目(2019YFS0296);四川省科技厅项目(2022YFSY0006);肿瘤医工创新基金项目(ZYGX2021YGCX015)。

摘　　要：目的 :构建一套由多学科团队参与、涵盖化疗用药全环节的肿瘤静脉化疗安全用药规范,为化疗药物规范化使用提供参考。方法 :以物理-事理-人理系统方法论为指导,采用文献研究法形成规范初稿,通过专家会议对初稿进行讨论和修订后形成咨询稿,应用德尔菲专家咨询形成终稿。结果 :共对18名专家进行了3轮专家咨询,问卷回收率均为100%,专家权威系数分别为0.895、0.890、0.885,总条目的肯德尔协调系数为0.147~0.166(均P<0.001),三级条目的可操作性肯德尔协调系数为0.168~0.207(均P<0.001)。肿瘤静脉化疗安全用药规范包括4个一级条目(人员、环境、流程、监测与随访)、14个二级条目、47个三级条目,以及36个条目说明。结论:本研究构建的肿瘤静脉化疗安全用药规范纳入了“医-药-护”多学科专业规范要求,包含人员资质、用药环境、用药流程、监测与随访等全流程,有利于静脉化疗实践的多学科沟通合作,促进化疗用药过程的规范化和同质化,保障患者化疗用药安全。Objective:To construct a set of safe medication standard for cancer intravenous chemotherapy,which involves the participation of multidisciplinary team and covers the entire process of chemotherapy medication usage,and to provide a reference for the standardized use of chemotherapy drugs.Methods:Based on WuLi-ShiLi-RenLi Approach,the first draft of the standard was formed by the literature research method.The consultation draft was formulated by discussing and revising the first draft through the expert meeting.And the final draft was determined by Delphi expert consultation.Results:A total of 18 experts were consulted in three rounds of expert consultation.The recovery rate of the questionnaire in the three rounds of consultations were all 100%.The expert authority coefficients were 0.895,0.890 and 0.885.The Kendall coordination coefficients of the total items were 0.147-0.166(all P<0.001).The operability Kendall coordination coefficients of the third-level items were 0.168-0.207(all P<0.001).The safe medication standard of intravenous chemotherapy for cancer contained 4 first-level items(staff,environment,process,monitoring and follow-up),14 second-level items,47 third-level items,and 36 item descriptions.Conclusion:The safe medication standard for cancer intravenous chemotherapy constructed in this study included the requirements of the multidisciplinary members of"medicine-pharmacy-nursing",which consist of staff qualifications,medication environment,medication process,monitoring and follow-up.The standard facilitates multidisciplinary communication and collaboration in the practice of intravenous chemotherapy,promotes the standardization and homogenization of the chemotherapy medication process,and ensures the safety of chemotherapy medication for patients.

关 键 词：物理-事理-人理系统方法论 静脉化疗 化疗用药 用药规范 化疗安全 

分 类 号：R473.73[医药卫生—护理学] R197[医药卫生—临床医学]