Investigation and analysis of the current situation of intravenous treatment of inpatients in a municipal tertiary general hospital
某市三级甲等综合医院住院患者静脉治疗现状调查分析

摘要

目的 了解某市三级甲等综合医院住院患者静脉治疗护理现状及存在的问题，为进一步提高医院静脉治疗质量以及为医院静脉治疗专科小组针对性的开展工作提供依据。方法 采用横断面调查的方法，使用BD公司设计的横断面调查小程序，于2021年12月27日9:00-12:00对全院68个涉及静脉治疗的科室2096位住院患者进行静脉治疗横断面调查。结果 本次调查总输液率为51.9％，静脉输液工具包括钢针、留置针、中心静脉置管（CVC）、经外周静脉置入的中心静脉导管（PICC）、输液港（PORT）、中线导管6种。其中，外周输液工具使用率为80%，中心静脉导管使用率为20%。钢针非单次输液占28.4%，外周静脉输液部位选择中49%未选择上臂，留置时间小于3天的占65.5%，有并发症的占14.1%，留置针使用中未使用安全型占63.9%，接头连接方式有针连接占29.1%，应用化疗药、肠外营养剂、血管活性药物等刺激性药物占20.8%。结论 静脉治疗护理技术操作虽日渐规范，但输液工具选择的科学性、穿刺部位选择合理性、导管日常维护的有效性、安全输液意识等，有待进一步加强。护理管理者应加强以上环节的质量控制，加大督查力度，持续改进提升静脉治疗质量，确保患者静脉治疗安全。

Abstract

Purpose: providing a basis for further improving the quality of intravenous therapy and for the targeted work of the hospital's intravenous therapy specialist group through investigate the current situation and existing problems of intravenous therapy nursing for inpatients in a Class III Grade A general hospital in a city.
Methods: Using the cross-sectional survey mini program designed by BD company, a cross-sectional survey of intravenous therapy was conducted on 2096 inpatients from 68 clinical departments of the hospital. The time was from 9:00 to 12:00 on December 27, 2021.
Results: The total infusion rate in this survey was 51.9%. There were 6 kinds of intravenous infusion tools, including steel needle, indwelling needle, central venous catheter (CVC), peripherally inserted central catheter (PICC), infusion PORT (PORT) and midline catheter. The usage rate of peripheral infusion tools was 80% and that of central venous catheters was 20%.The rate of non-single infusion of steel needle was 28.4%.There were 49% patientsdid not choose the upper armin the selection of peripheral intravenous infusion sites. The indwelling time less than 3 days accounted for 65.5% and the proportion of patients with complications was 14.1%..In the use of indwelling needles, 63.9% of the patientsdid not use the safe type and the needle connection accounted for 29.1%. The use of chemotherapy, parenteral nutrition, vasoactive drugs and other stimulant drugs accounted for 20.8%.
Conclusion  : Although the technical operation of intravenous therapy and nursing is increasingly standardized, the scientific selection of infusion tools, the rationality of puncture site selection, the effectiveness of catheter daily maintenance, and the awareness of safe infusion need to be further strengthened. Nursing managers should strengthen the quality control in the above links, increase supervision, continuously improve the quality of intravenous therapy, so as to ensure the safety of intravenous therapy for patients.