三级医院护士对β内酰胺类抗菌药物皮肤试验认知的现状研究  

Status quo of nurses’cognition of skin test ofβ-lactam antibiotics in tertiary hospital

作　　者：季单单 胡必杰 高晓东 郑峥 袁征 JI Dandan;HU Bijie;GAO Xiaodong;ZHENG Zheng;YUAN Zheng(Nursing Department,Zhongshan Hospital,Fudan University,Shanghai 200032,P.R.China;Department of Infectious Diseases,Zhongshan Hospital,Fudan University,Shanghai 200032,P.R.China;Department of Hospital Infection Management,Zhongshan Hospital,Fudan University,Shanghai 200032,P.R.China)

机构地区：[1]复旦大学附属中山医院护理部,上海200032 [2]复旦大学附属中山医院感染病科,上海200032 [3]复旦大学附属中山医院感染管理科,上海200032

出　　处：《华西医学》2024年第3期455-460,共6页West China Medical Journal

基　　金：上海申康医院发展中心临床科技创新项目(SHDC22021315)。

摘　　要：目的了解我国三级医院护士对β内酰胺类抗菌药物皮肤试验认知现状及其影响因素。方法2023年3月—5月,采用多阶段抽样法抽取我国东部和西部地区三级医院的护士。采用基于国家卫生健康委员会发布的《β内酰胺类抗菌药物皮肤试验指导原则(2021年版)》编制的《β内酰胺类抗菌药物皮肤试验认知现状调查表》,借助问卷星平台进行多中心调查。结果共调查三级医院89家。其中,东部27家,西部62家;综合性医院64家,专科医院25家。共纳入护士4241例,其中女性4151例,男性90例。护士对β内酰胺类抗菌药物皮肤试验认知现状调查表平均得分为(61.47±16.27)分。调查结果显示,正确率在15.52%~88.98%;仅头孢菌素类药物用药前常规是否需要皮肤试验、皮肤试验结果的判断、发生过敏后输液器的更换的正确率大于80%。Logistics回归分析结果显示,职称和近2年接受过抗菌药物管理相关培训是护士对β内酰胺类抗菌药物皮肤试验认知水平的影响因素(P<0.001)。结论当前我国三级医院护士对β内酰胺类抗菌药物皮肤试验认知情况尚存不足,建议医院结合指南形成相应的院内β内酰胺类抗菌药物皮肤试验护理团体标准并加强对护士这方面的培训,提高护士对β内酰胺类抗菌药物皮肤试验的正确认知,从而促使护士规范实施皮肤试验,提升皮肤试验结果的准确性,进一步促进β内酰胺类抗菌药物合理使用。Objective To investigate the status of nurses’cognition of skin test forβ-lactam antibiotics in tertiary hospitals in China and its influencing factors.Methods The nurses in the eastern and western regions were selected by stratified sampling and convenient sampling between March and May 2023.A multi-center survey was conducted with the help of the questionnaire star platform using the“Questionnaire on the Cognitive Status ofβ-lactam Antibiotics Skin Test”developed by the“Guidelines forβ-lactam Antibiotics Skin Test(2021 Edition)”issued by the National Health Commission of the reference country.Results A total of 89 tertiary hospitals were surveyed.Among them,there were 27 in the eastern regions and 62 in the western regions;There were 64 comprehensive hospitals and 25 specialized hospitals.A total of 4241 nurses were included.Among them,4151 were females and 90 were males.The scores of nurses’cognition of skin test ofβ-lactam antibiotics were(61.47±16.27).The survey results showed that the accuracy rate ranges from 15.52%to 88.98%.Only no routine skin test before cephalosporin administration,judgment of skin test results,and infusion device replacement after allergy were greater than 80%.The results of the logistic regression analysis showed that the nurses with professional titles and antimicrobial management training in the past 2 years were independent influencing factors of nurses’cognition of skin test ofβ-lactam antibiotics(P<0.001).Conclusions At present,nurses in tertiary hospitals in China still have insufficient knowledge of skin test ofβ-lactam antibiotics.It is suggested that hospitals should form corresponding hospital skin test ofβ-lactam antibiotics standards in combination with guidelines and strengthen training for nurses in this regard,so as to improve nurses’correct cognition and implementation of skin test ofβ-lactam antibiotics.

关 键 词：内酰胺类抗菌药物 皮肤试验 多中心 过敏 

分 类 号：R197.32[医药卫生—卫生事业管理]