Dunne K, Sullivan K, Garvey A, Kernohan G, Diamond A, Duffy C, Hutchinson J
North and West In-Service Education Consortium, Altnagelvin Hospital, Londonderry, Northern Ireland.
Int J Palliat Nurs. 2000 May;6(5):214-9. doi: 10.12968/ijpn.2000.6.5.8922.
The use of syringe drivers as a method of drug delivery to control symptoms in palliative care is a common and accepted practice, but one which has evolved rather than been subject to close multiprofessional scrutiny and guideline formation. There is evidence that adverse incidents may arise as a result of syringe driver use (Medical Devices Agency (MDA), 1998), for example, errors in drug calculations, drug stability, equipment failure (including disconnection) and the wrong rate of infusion. Inadequate user training, poor servicing of equipment and inadequate documentation and record keeping are all thought to be contributing factors (MDA, 1998). In the hospital where this audit was carried out, syringe drivers are used to administer drugs to patients with cancer during the palliative phase of illness. The purpose of this clinical audit was to establish the standard of current practice in wards where syringe drivers were being used. A retrospective study of 13 cases of syringe driver use is presented. The results highlight many areas of unregulated practice with regard to setting up, monitoring and maintenance of syringe drivers. The choice of drugs and doses prescribed, evaluation of treatment responses and review of treatment regimens were also areas of concern. Guidelines for the use of syringe drivers in non-specialist hospitals are put forward.
在姑息治疗中，使用注射器泵作为一种给药方法来控制症状是一种常见且被认可的做法，但这一做法是逐渐发展而来的，而非经过多专业的严格审查并形成指南。有证据表明，使用注射器泵可能会引发不良事件（医疗器械局（MDA），1998年），例如，药物计算错误、药物稳定性问题、设备故障（包括断开连接）以及输注速度错误。用户培训不足、设备维护不善以及文档记录不充分都被认为是促成因素（MDA，1998年）。在进行此次审核的医院中，注射器泵用于在疾病的姑息阶段为癌症患者给药。本次临床审核的目的是确定使用注射器泵的病房当前的实践标准。本文呈现了对13例使用注射器泵情况的回顾性研究。结果突出了在注射器泵的设置、监测和维护方面许多未规范的实践领域。所开药物和剂量的选择、治疗反应的评估以及治疗方案的审查也是令人关注的领域。本文提出了非专科医院使用注射器泵的指南。
