影响急诊室临床医生的外周静脉导管实践的因素:定性分析
Hui Grace Xu1, Amanda J Ullman2, Claire M Rickard3
1NHMRC Centre of Research Excellence (CRE) in Wiser Wound Care, Menzies Health Institute, Queensland, Griffith University, Nathan, Brisbane, Queensland, Australia; School of Nursing and Midwifery, Queensland University of Technology, Kelvin Grove, Brisbane, Queensland, Australia; Centre of Clinical Nursing, Royal Brisbane and Women's Hospital, Herston, Brisbane, Queensland, Australia; Emergency Department, Queen Elizabeth II Jubilee Hospital, Brisbane, Queensland, Australia; Alliance for Vascular Access Teaching and Research, Schools of Nursing and Midwifery and Pharmacy and Medical Sciences, Griffith University, Brisbane, Australia.
澳大利亚的急诊医生面临着坚持国家外周静脉导管 (PIVC) 质量标准的挑战. 不足够的知识和感知的不可行性阻碍了最佳的PIVC实践.
科学领域:
- 紧急医疗 紧急医疗
- 改善医疗保健质量 改善医疗保健质量
- 护理实践 护理实践
背景情况:
- 周围静脉注射导管 (PIVC) 在急诊室 (ED) 中是必不可少的.
- 影响澳大利亚临床医生遵守国家PIVC质量和安全标准的因素尚不清楚.
- 了解这些因素对于改善患者护理和安全至关重要.
研究的目的:
- 探索急诊室 (ED) 临床医生对PIVC插入和护理的态度和经验.
- 确定遵守国家PIVC质量和安全标准的障碍.
主要方法:
- 探索性定性研究,使用在线全国调查,带有开放式问题.
- 雪球采样方法招募参与者.
- 对340份书面答复的演分析,主要来自公共ED的护士.
主要成果:
- 鉴定出的非最佳实践包括置导管,患者参与,插入部位,多次尝试,部位准备,文档和PIVC审查等问题.
- 坚持的关键障碍包括知识不足,感知不可行性,对证据的不信任,不清楚的责任,习惯性做法,培训不足,缺乏认可和不良参与.
- 这些因素共同阻碍了PIVC标准的一致应用.
结论:
- ED临床医生遵守PIVC标准受到复杂,多因素问题的影响.
- 有针对性的战略和干预措施是必要的,以促进PIVC标准的实施.
- 可持续的行为改变是需要实现一致的遵守和改善患者的结果.
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