Gao Peng, Wu Yanshuo, Wu Xinhui, Bai Jing, Shen Kangkang, Yin Yanling
Department of Critical Care Medicine, Fourth Hospital of Hebei Medical University, Shijiazhuang, 050000, People's Republic of China.
Department of Pharmacy, Fourth Hospital of Hebei Medical University, Shijiazhuang, 050000, People's Republic of China.
J Multidiscip Healthc. 2024 Oct 17;17:4793-4801. doi: 10.2147/JMDH.S478218. eCollection 2024.
To explore the effect of the Integrated Management Model of Doctor-Nurse-Pharmacist Collaboration on the Safety of Intravenous Therapy in Critically Ill Patients.
1587 patients who were hospitalized in the Intensive Care Department of the Fourth Hospital of Hebei Medical University in China from January 2021 to December 2022 were selected. 768 patients before the implementation of the integrated medical, nursing, and drug management model were selected as the control group, and 819 patients who implemented the integrated medical, nursing, and drug management model were selected as the observation group.
Compared with the control group, the incidence of drug compatibility contraindications in the observation group decreased from 3.5% to 1.5% (χ=6.957 =0.008), the central venous catheter (CVC) blockage rate decreased from 2.5% to 1.0% (χ=5.249 =0.022), the daily incidence of catheter related bloodstream infections decreased from (1.84 ± 2.17) to (0.91 ± 1.19)(t=6.988 =0.015), and the incidence of peripheral venous treatment related complications decreased from 10.3% to 2.9% (χ=16.663 =0.000). Among them, the incidence of phlebitis decreased from 5% to 1.6% (χ=4.817 =0.028). The incidence of drug exudation decreased from 3.4% to 0.8% (χ2=0.031 =0.019). The incidence of extravasation has decreased from 2.5% to 0.4% (χ=0.044 =0.027). The differences were statistically significant (<0.05).
The Integrated Management Model of Doctor-Nurse-Pharmacist Collaboration significantly reduced the incidence of catheter-related bloodstream infections (CRBSI), drug incompatibility, and other intravenous therapy-related complications, thereby enhancing the safety of intravenous therapy in critically ill patients.
探讨医护药协同整合管理模式对重症患者静脉治疗安全性的影响。
选取2021年1月至2022年12月在中国河北医科大学第四医院重症监护科住院的1587例患者。选取实施医护药一体化管理模式前的768例患者作为对照组，选取实施医护药一体化管理模式的819例患者作为观察组。
与对照组相比，观察组药物配伍禁忌发生率由3.5%降至1.5%（χ²=6.957，P =0.008），中心静脉导管（CVC）堵塞率由2.5%降至1.0%（χ²=5.249，P =0.022），导管相关血流感染日发生率由（1.84±2.17）降至（0.91±1.19）（t =6.988，P =0.015），外周静脉治疗相关并发症发生率由10.3%降至2.9%（χ²=16.663，P =0.000）。其中，静脉炎发生率由5%降至1.6%（χ²=4.817，P =0.028）。药物渗出发生率由3.4%降至0.8%（χ²=0.031，P =0.019）。外渗发生率由2.5%降至0.4%（χ²=0.044，P =0.027）。差异具有统计学意义（P<0.05）。
医护药协同整合管理模式显著降低了导管相关血流感染（CRBSI）、药物配伍禁忌及其他静脉治疗相关并发症的发生率，从而提高了重症患者静脉治疗的安全性。
