外围静脉导管的政策和实践是否符合临床标准? 一个点患病率研究的研究
Josephine Lovegrove1, Sally Havers2, Jessica Schults3
1National Health and Medical Research Council Centre of Research Excellence in Wiser Wound Care, School of Nursing and Midwifery, Griffith University, Southport, QLD, 4222, Australia; Herston Infectious Diseases Institute, Metro North Health, Herston, QLD, 4029, Australia; School of Nursing, Midwifery and Social Work, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland, UQCCR, Herston, QLD, 4029, Australia; Alliance for Vascular Access Teaching and Research, Griffith University, Southport, QLD, 4222, Australia.
遵守澳大利亚外周静脉导管 (PIVC) 临床护理标准的水平较低,在实践中存在显著差异. 改善PIVC护理需要更新的指导方针和策略,以确保一致的患者安全.
科学领域:
- 改善医疗保健质量 改善医疗保健质量
- 护理中的患者安全
- 临床实践标准 临床实践标准
背景情况:
- 周围静脉注射导管 (PIVC) 由于护理不一致而容易出现并发症,这会影响患者的安全.
- 澳大利亚"外围静脉导管临床护理管理标准"概述了预期的护理方案.
- 目前在医院政策和实践中采用PIVC标准的情况尚未评估.
研究的目的:
- 评估澳大利亚PIVC临床护理标准在急性病房的遵守程度.
- 识别PIVC管理政策和实践中的变化.
主要方法:
- 在21家医院的134个急性病房进行了一项多地点点患病率研究.
- 使用结构和过程指标来衡量标准的10个质量声明的遵守程度.
- 收集了有关患者特征和PIVC护理实践的数据.
主要成果:
- 对结构性指标的遵守率在19%至43%之间.
- 过程指标的遵守率在治疗用途 (91%) 和包装完整性 (81%) 中高,但在记录的插入指示 (80%) 和持续需求评估 (61%) 中较低.
- 只有20%的质量声明实现了整体二进制合规,其中53%的PIVC在曲区域,42%的PIVC记录了每8小时一次的检查.
结论:
- 在PIVC的护理政策和实践中存在显著的不合理的差异,尽管已建立的临床标准.
- 迫切需要改革当地指导方针和医院流程,以规范PIVC护理.
- 加强遵守PIVC临床护理标准的策略对于改善患者安全至关重要.
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