Application of risk nursing combined with continuous quality improvement in the safety management of intravenous drug use in daytime chemotherapy
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摘要:
目的 日间化疗患者静脉用药具有一定危险性，为了提高患者用药安全，本研究在常规护理基础上应用风险护理联合持续质量改进，评估其护理价值和意义。 方法 采用便利抽样法选取2019年5—12月在湖州市中心医院进行日间化疗静脉用药的患者140例作为对照组，采用常规护理质量管理方法；并选取2020年5—11月进行日间化疗静脉用药的患者150例作为观察组，应用风险护理联合持续质量改进护理管理。比较2组患者护理质量评分、药物素养评分、护理不良事件发生率及护理满意度。 结果 观察组患者护理质量各项评分及总分均高于对照组(均P < 0.05)；护理干预前，2组患者药物素养评分比较差异无统计学意义(P>0.05)；护理干预后，2组患者评分均有所升高，观察组患者评分明显高于对照组(均P < 0.05)；观察组护理满意度为94.7%(142/150)，对照组为87.1%(122/140)，2组比较差异有统计学意义(P < 0.05)。 结论 风险护理联合持续质量改进可在常规治疗及护理的基础上有效降低日间化疗患者静脉用药各环节的风险，减少了护理不良事件的发生，有效提高了患者药物素养及护理满意度，在日间化疗静脉用药安全管理中具有一定积极意义。 Abstract:Objective To improve the safety management of drug use in patients undergoing daytime chemotherapy, this study used risk nursing combined with continuous quality improvement on the basis of routine nursing to evaluate the nursing value and significance of the strategy. Methods A total of 140 patients who received intravenous chemotherapy in our hospital from May 2019 to December 2019 were included in the control group through convenient sampling. They underwent routine nursing quality management. A total of 150 patients admitted to the Cardiology Department of our hospital were included in the observation group and subjected to risk nursing, which was combined with continuous quality for the improvement of nursing management. Nursing quality and drug literacy scores, incidence of nursing adverse events and nursing satisfaction were compared between the groups. Results The scores and total scores of nursing quality in the observation group were higher than those in the control group (P < 0.05). Before nursing intervention, there was no significant difference in drug literacy score between the two groups (P>0.05). After the nursing intervention, the scores of the two groups were increased, but the scores of the observation group were significantly higher than those of the control group (P < 0.05). The nursing satisfaction of the observation group was 94.7% (142/150), and that of the control group was 87.1% (122/140), the difference was statistically significant (P < 0.05). Conclusion Risk nursing combined with continuous quality improvement can effectively reduce the risk of intravenous drug use in patients undergoing daytime chemotherapy on the basis of routine treatment and nursing, reduce the occurrence of adverse nursing events, effectively improve the patient's drug literacy and nursing satisfaction. This strategy is of great significance to the safety management of intravenous drug use in daytime chemotherapy. -
Key words:
- Risk nursing /
- Continuous quality improvement /
- Day ward /
- Intravenous chemotherapy /
- Medication safety
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表 1 2组日间化疗静脉用药患者护理质量评分比较(x ±s，分)
组别 例数 护理评估 基础护理 专科护理 护理操作 正确给药 仪器使用 急救护理 健康宣教 风险识别 护理文书 总分 对照组 140 7.23±0.47 7.69±0.36 7.17±0.25 7.29±0.44 7.71±0.35 7.66±0.48 7.08±0.24 7.21±0.52 7.31±0.42 7.81±0.26 76.82±6.33 观察组 150 8.23±0.27 9.01±0.13 8.71±0.46 8.15±0.43 9.03±0.22 8.73±0.36 8.14±0.77 8.78±0.49 8.15±0.32 8.81±0.73 88.91±5.26 t值 22.399 42.069 35.069 16.829 38.719 21.566 15.595 26.471 19.234 15.325 17.735 P值 ＜0.001 ＜0.001 ＜0.001 ＜0.001 ＜0.001 ＜0.001 ＜0.001 ＜0.001 ＜0.001 ＜0.001 ＜0.001 
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表 2 2组日间化疗静脉用药患者药物素养评分比较(x ±s，分)
组别 例数 药物素养评分 t值 P值 护理前 护理后 对照组 140 4.23±1.17 5.26±0.47 9.666 < 0.001 观察组 150 4.15±1.26 6.33±0.11 21.110 < 0.001 t值 0.561 26.274 P值 0.575 < 0.001
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表 3 2组日间化疗静脉用药患者护理满意度比较[例(%)]
组别 例数 非常满意 满意 一般 不满意 护理满意度 对照组 140 54（38.6） 68（48.5） 10（7.1） 8（5.8） 122（87.1） 观察组 150 93（62.0） 49（32.7） 6（4.0） 2（1.3） 142（94.7） 注：2组护理满意度比较，χ2=5.022，P=0.025。
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