Spath M L, Rimkus C F, Saenz D A
St. Louis University Health Sciences Center, MO, USA.
Oncol Nurs Forum. 1998 Jan-Feb;25(1):129-35.
PURPOSE/OBJECTIVES: To describe the development and evaluation of a documentation tool for chemotherapy and infusion therapy for an outpatient oncology setting.
Journal articles, documentation tools, and cancer chemotherapy guidelines.
Greater demands and expansion of treatments and procedures in the outpatient setting have necessitated documentation methods that conserve time, accommodate documentation of a variety of therapies, and communicate ongoing monitoring and evaluation of care. Flow sheet documentation is an acceptable documentation method that has been used extensively to meet these objectives.
Use of this flow sheet has improved the quality and accommodated the scope of infusion therapy in the authors' setting. Documentation time has decreased, and standardization of documentation has occurred.
Nurses can use the flow sheet to document concisely chemotherapy and infusion therapy administration over a period of time. It also provides for continuity in patient assessment and education through easy accessibility of this information within the patient's chart.
目的/目标:描述一种用于门诊肿瘤治疗环境中化疗和输液治疗的记录工具的开发与评估。
期刊文章、记录工具和癌症化疗指南。
门诊环境中对治疗和程序的需求增加且范围扩大,因此需要节省时间、能记录各种疗法并传达持续护理监测与评估的记录方法。流程图记录是一种可接受的记录方法,已被广泛用于实现这些目标。
在作者所在的环境中,使用该流程图提高了输液治疗的质量并适应了其范围。记录时间减少,记录实现了标准化。
护士可使用该流程图简洁地记录一段时间内的化疗和输液治疗给药情况。通过在患者病历中轻松获取这些信息,它还能确保患者评估和教育的连续性。