A survey and analysis of the status quo of implementation of Intravenous Practice Standard in a tertiary A hospital_West China Medical Journal

Authors：

HU Yanjie ^1,1 , LUO Yanli ^1,1 , TAN Qiling ^2,2 ,  HU Xiuying ^3,3

1. Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Third Comprehensive Ward, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. Nursing Department, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

HU Xiuying, Email: xiuying.hu@163.com

Keywords：

Intravenous Practice Standard; Intravenous therapy; Cross-sectional survey

DOI：

10.7507/1002-0179.201608329

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Objective To investigate the status quo of implementation ofIntravenous Practice Standard in a tertiary A hospital in Sichuan. Methods At 09:00-11:30 am, on March 16th, 2016, a questionnaire designed by intravenous team (IV Team) was used to conduct the investigation in all the inpatiets according to inclusion and exclusion criteria. The SPSS 17.0 software was used to perform all statistical analysis. Results The intravenous infusion rate in the hospital was 76.87%, while the rate in Emergency Department peaked up to 96.11%. Indwelling needle was the most common used device for intravenous therapy in clinical practice, which was used in 77.91% of the inpatients, and steel needle, peripherally inserted central catheter (PICC), central venous catheter, and implantable venous access port were also widely used. Peripheral intravenous catheter was used in 2 990 inpatients, and 78.12% of the puncture sites met the standard; PICC was used in 397 inpatients, and 90.17% of the puncture sites met the standard. The incidence of intravenous infusion related-complications was 15.08%, the incidence of drug exosmosis / exudation was 10.06%, and the incidence of catheter-related blood stream infection (CRBSI) was 2.89%. Conclusions On the whole, the intravenous infusion rate in this hospital accords with the national average level, but the rate in some departments should be controlled. The selection of device for intravenous therapy is reasonable, but the selection of intravenous site should be more standardized. The incidence of intravenous infusion related-complications is low, but the prevention and control of drug exosmosis / exudation and CRBSI should be reinforced. Health care organizations should pay more attention to enforce the Intravenous Practice Standard into practice to promote clinical medical service.

Citation： HU Yanjie, LUO Yanli, TAN Qiling, HU Xiuying. A survey and analysis of the status quo of implementation of Intravenous Practice Standard in a tertiary A hospital. West China Medical Journal, 2017, 32(10): 1572-1575. doi: 10.7507/1002-0179.201608329 Copy

1.	吳欣娟, 孫文彥, 曹晶. 規范靜脈治療保障患者安全——《靜脈治療護理技術操作規范》的起草與編制. 中國護理管理, 2013, 13(3): 1-3.
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13.	Gonzalez Lopez JL, Arribi Vilela A, Fernandez Del Palacio E, et al. Indwell times, complications and costs of open <italic>vs</italic> closed safety peripheral intravenous catheters: a randomized study. J Hosp Infect, 2014, 86(2): 117-126.
14.	Rickard CM, Webster J, Marianne CW, et al. Routine <italic>versus</italic> clinically indicated replacement of peripheral intravenous catheters: a randomised controlled equivalence trial. Lancet, 2012, 380(9847): 1066-1074.
15.	Rubak S, Mortensen L, Ringsted C, et al. A controlled study of the short- and long-term effects of a Train the Trainers course. Med Educ, 2008, 42(7): 693-702.
16.	張敏, 聶雷霞, 李威, 等. " 行政業務教學”循環遞進式靜脈治療專科護理查房的實踐與效果評價. 護理研究, 2015, 22(22): 2791-2793.
17.	Schulmeister L. Management of Non-Infectious central venous access device complications. Oncology Nursing, 2010, 4(2): 88-101.
18.	王丹, 石婧, 張玲. 護士靜脈輸液風險意識現狀及相關因素. 護理管理雜志, 2015, 15(2): 129-131.

1. 吳欣娟, 孫文彥, 曹晶. 規范靜脈治療保障患者安全——《靜脈治療護理技術操作規范》的起草與編制. 中國護理管理, 2013, 13(3): 1-3.
2. 趙林芳. 注重細節管理提升靜脈治療安全性. 中國護理管理, 2014, 6(6): 566-569.
3. Park JY. Implementing a central venous catheter self-management education program for patients with cancer. Eur J Oncol Nurs. 2016 (25): 1-8.
4. 國家衛生和計劃生育委員會. 靜脈治療護理技術操作規范. 中國護理管理, 2014, 1(5): 1-4.
5. 吳安華, 任南, 文細毛, 等. 156 家醫院住院患者靜脈輸液的流行病學調查. 中華流行病學雜志, 2004, 25(10): 916-917.
6. 黎介壽. 對 Fast-track surgery 內涵的認識. 中華普外科手術學雜志:電子版, 2007, 1(1): 1-4.
7. Holte K, Kehlet H. Compensatory fluid administration for preoperative dehydration - does it improve outcome? Acta Anaesthesiol Scand, 2002, 46(9): 1089-1093.
8. Miller TE, Roche AM, Mythen M. Fluid management and goal-directed therapy as an adjunct to Enhanced Recovery After Surgery (ERAS). Can J Anaesth. 2015, 62(2): 158-168.
9. 吳茜, 陳靜娟, 沈蓉蓉, 等. 多學科合作快速康復外科模式中護理的作用. 中國護理管理, 2014, 2(2): 215-218.
10. Mereness D. Expanding roles-recent trends in nursing. AORN J, 1970, 12(6): 158, 161-162, 167-171, 173.
11. Keogh S, Marsh N, Higgins N, et al. A time and motion study of peripheral venous catheter flushing practice using manually prepared and prefilled flush syringes. J Infus Nurs, 2014, 37(2): 96-101.
12. Vizcarra C, Cassutt C, Corbitt N, et al. Recommendations for improving safety practices with short peripheral catheters. J Infus Nurs, 2014, 37(2): 121-124.
13. Gonzalez Lopez JL, Arribi Vilela A, Fernandez Del Palacio E, et al. Indwell times, complications and costs of open <italic>vs</italic> closed safety peripheral intravenous catheters: a randomized study. J Hosp Infect, 2014, 86(2): 117-126.
14. Rickard CM, Webster J, Marianne CW, et al. Routine <italic>versus</italic> clinically indicated replacement of peripheral intravenous catheters: a randomised controlled equivalence trial. Lancet, 2012, 380(9847): 1066-1074.
15. Rubak S, Mortensen L, Ringsted C, et al. A controlled study of the short- and long-term effects of a Train the Trainers course. Med Educ, 2008, 42(7): 693-702.
16. 張敏, 聶雷霞, 李威, 等. " 行政業務教學”循環遞進式靜脈治療專科護理查房的實踐與效果評價. 護理研究, 2015, 22(22): 2791-2793.
17. Schulmeister L. Management of Non-Infectious central venous access device complications. Oncology Nursing, 2010, 4(2): 88-101.
18. 王丹, 石婧, 張玲. 護士靜脈輸液風險意識現狀及相關因素. 護理管理雜志, 2015, 15(2): 129-131.

West China Medical Journal

A survey and analysis of the status quo of implementation of Intravenous Practice Standard in a tertiary A hospital

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