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中国护理管理 ›› 2024, Vol. 24 ›› Issue (10): 1503-1509.doi: 10.3969/j.issn.1672-1756.2024.10.013

• 儿科护理专题 • 上一篇    下一篇

儿童肠外营养给药循证临床决策支持方案的干预效果评价

何梦雪 顾莺 黄勤 张晓波 胡雁   

  1. 复旦大学护理学院，复旦大学循证护理中心，200030 上海市（何梦雪，胡雁）；上海交通大学医学院附属上海儿童医学中心（何梦雪）；复旦大学附属儿科医院（顾莺，黄勤，张晓波）
  • 出版日期:2024-10-15 发布日期:2024-10-15
  • 通讯作者: 胡雁，博士，教授，院长，E-mail:huyan@fudan.edu.cn
  • 作者简介:何梦雪，博士，副主任护师，护士长
  • 基金资助:
    上海市地方高水平大学建设项目（FNDGJ202003）

Effectiveness evaluation of Pediatric Parenteral Nutrition Intravenous Administration Evidence-adaptive Clinical Decision Support System administration on medication safety behavior

HE Mengxue, GU Ying, HUANG Qin, ZHANG Xiaobo, HU Yan   

  1. School of Nursing Fudan University, Shanghai, 200030, China
  • Online:2024-10-15 Published:2024-10-15
  • Contact: E-mail:huyan@fudan.edu.cn

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摘要： 目的：验证儿童肠外营养给药循证临床决策支持方案对护士给药安全行为依从性的干预效果，以提升安全水平。方法：2021年11月至2022年8月，采取阶梯设计整群随机对照试验方法，以上海市某三级甲等儿童专科医院的5个病区为实施场所，依次纳入阶梯实施儿童肠外营养给药循证临床决策支持方案，比较实施前后护士给药安全行为依从性。结果：儿童肠外营养给药循证临床决策支持方案实施后，护士肠外营养给药前评估执行率由0增至100.0%；双核对执行率、经中心静脉导管输注执行率显著提升（P<0.05）；每小时巡视评估执行率提高不明显（P>0.05）。结论：儿童肠外营养给药循证临床决策支持方案有助于儿科护士完成肠外营养给药前评估、执行双核对、选择正确导管，规范护士给药安全行为。

关键词: 临床决策支持系统；肠外营养；儿童；给药

Abstract: Objective: To evaluate the effectiveness of Pediatric Parenteral Nutrition Intravenous Administration Evidence-adaptive Clinical Decision Support System (PN-CDSS) on nurses' compliance with safe Parenteral Nutrition (PN) administration behaviors. Methods: From November 2021 to August 2022, a step-wedge cluster randomized controlled trial of the implementation plan of PN-CDSS was conducted in five wards of a tertiary grade A pediatric specialty hospital in Shanghai. Nurses in these departments were intervened, with each ward being included in the step as per the randomization results. The compliance of nurse medication safety behaviors before and after implementation were compared. Results: After the implementation of PN-CDSS, the rate of pre-administration assessment for PN increased from 0 to 100.0%. And significant improvements were observed in the double-checking rate for PN and the execution rate of PN infusion via a Central Venous Catheter (P<0.05). However, there was no significant change in the rate of hourly assessment for PN (P>0.05). Conclusion: The PN-CDSS aid pediatric nurses in conducting pre-administration assessments, performing double checks and choosing right catheter, thereby enhancing the nursing medication administration safety behaviors.

Key words: Clinical Decision Support System; Parenteral Nutrition; children; medication administration

中图分类号:  R47；R197
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