Patel Chandni, Morgan Dafydd
Royal Free Trust, London.
BMJ Qual Improv Rep. 2015 Oct 22;4(1). doi: 10.1136/bmjquality.u207156.w3400. eCollection 2015.
Venesection is a widely practised procedure, involving the removal of a unit of blood in order to treat haemochromatosis and polycythaemia. It is still well regarded due to a lack of better alternatives and a small side effect profile. At Barnet General Hospital, venesection has recently been a physician led service, unlike its neighbouring hospital at Chase Farm Hospital, which has a well run nurse led service. The current service being run at Barnet Hospital was beset with problems, including delays in service provision and discharge, using junior doctors who may not be comfortable with or have knowledge of pre and post procedure checks. Furthermore, the medical day treatment unit is comprised of highly skilled nurses. 100% of nursing staff felt comfortable gaining venous access, but none had any formal training. Following a practical tutorial, followed by formal teaching, the nurses now run the venesection service. This has been done at no cost to the hospital, has sped up discharges and this has subsequently led to the capacity of the unit to venesect patients to increase by 100%.
放血疗法是一种广泛应用的治疗手段，通过抽取一定量的血液来治疗血色素沉着症和红细胞增多症。由于缺乏更好的替代方法且副作用较小，它至今仍备受认可。在巴尼特综合医院，放血疗法最近一直由医生主导，这与邻近的蔡斯农场医院不同，后者有一项运作良好的由护士主导的服务。巴尼特医院目前开展的这项服务存在诸多问题，包括服务提供和出院延迟，使用的初级医生可能对操作前后的检查不熟悉或缺乏相关知识。此外，日间医疗单元配备了技术高超的护士。100%的护理人员对进行静脉穿刺感到得心应手，但他们都没有接受过正规培训。经过一次实践指导，随后进行正式教学后，现在由护士负责放血疗法服务。这对医院来说没有成本增加，加快了出院速度，随后该科室为患者进行放血治疗的能力提高了100%。
