连续静脉输液最小安全余液量概念的建立及应用效果

目的建立连续静脉输液最小安全余液量的概念,为确定连续静脉输液过程中的最佳液体更换时机提供依据。方法对8名护士采用面对面小组深度访谈确定最小安全余液量标准;测量14种北京市目前使用的输液器,建立直线回归方程,建立最小安全余液量概念和评价标准。将2011年11月神经科病房收治每日输液4瓶以上的40例患者分为两组,研究组由护士指导使用最小安全余液量标准判断液体更换时机;对照组为常规健康教育组。比较每次更换液体时患者呼叫情况和护士判断结果:患者呼叫记为"是",未呼叫记为"否";统计护士更换液体时余液量等于、小于、大于安全余液量的比例,观察时间为14d。在患者进入本项研究后14d由第三方人员现场发放调查问卷,评价患者对巡视环节的满意度。结果两组患者共更换液体2 992例次,其中研究组1 524例次,对照组1 468例次。研究组和对照组患者余液量小于、等于、大于安全余液量情况的发生率及静脉输液呼叫发生率差异有统计学意义(Ρ<0.01);研究组及对照组呼叫的例数中,余液量小于、等于和大于安全余液量所占的比例,差异有统计学意义(Ρ<0.01)。研究组余液量不足的178例中,患者呼叫占44.38%;对照组余液量不足的612例中,患者呼叫占64.71%,差异有统计学意义(Ρ<0.01)。两组患者对静脉输液巡视满意度,研究组为(28.00±0.67)分、对照组为(24.85±1.16)分,差异有统计学意义(Ρ<0.05)。结论建立和应用连续静脉输液最小安全余液量概念可以提高静脉输液护理工作的有效性和安全性,降低护理风险,改善护理工作满意度。

Establishment and Efficiency Evaluation of the Concept of Minimum Safe Remaining Volume in Continuous Intravenous Infusion

Objective To establish the concept of minimum safe remaining volumes in continuous intravenous infusion,so as to provide the basis to determine the optimal time to replace solution in the process of continuous intravenous infusion.MethodsEight nurses were interviewed face-to-face to determine the minimum safe remaining volumes and 14 kinds of IV sets which were being used in Beijing were measured to establish the concept of minimum safe remaining volumes and evaluation criterion in continuous intravenous infusion by calculating the linear regression equation.Then,there was an experimental study in which 40 patients who received at least 4 solutions each day wereindwelled in November 2011.They were dividedrandomly into control and experimental group.In the experimental group,nurses determined the time to replace liquids under the guidance of minimum safe remaining volumes,and in the control group,nurses adopted the routine health education.Comparisons were conducted on the calling status of patients and the judgments of nurses during each replacement of liquids： patients＇ calling were noted as ＂yes＂ and no calling as ＂no＂;the proportions of the remaining volumes which were equal to,less than,greater than the safe remaining volumes were calculated.The observation lasted for 14 days.After the 14-day treatment,the patients enrolled in this study were surveyed by the third-party personnel to evaluate the satisfaction of nursing visiting.ResultsTotally 2 992 cases replaced solutions in both groups,with 1 524 cases in the experimental group and 1 468 cases in the control group.The occurrences of solution volumes less than,equal to and more than safe remaining volume and patient call during intravenous infusion in the two groups were significantly different（Ρ0.01）.Of the experimental group,the ratio of the solution volumes less than,equal to and more than safe remaining volume in calling status of patients were significantly different between the two groups（Ρ0.01）.Of the 178 cases with insufficient remaining solutions in the experimental group,patients call accounted for 44.38%.Of the 612 cases with insufficient remaining solutions in the control group,patients call accounted for 64.71%.There were significant differences between the two groups（Ρ0.01）.The patients＇ satisfaction scores in the experimental group and the control group were 28.00±0.67 and 24.85±1.16,respectively,which showed significant difference between the two groups（Ρ0.05）.ConclusionThe study shows that establishing and using the concept of minimum safe remaining solution volumes in continuous intravenous infusion can improve the efficacy and safety of intravenous infusion nursing,reduce the risk of nursing,and improve nursing satisfaction.