摘要
目的 了解临床医师输血告知义务履行现状及相关因素,为提高输血告知义务履行质量措施的制定提供科学依据。方法 采用现况调查方法,以某三甲医院2019年4月1日至6月30日144名至少进行过1次红细胞输血医嘱的临床医师作为研究对象,以英国输血审核中关于医师履行输血知情同意告知调查问卷条目为主体修订的调查表作为调查工具,主要内容包括研究对象一般情况和15条输血核心条目的告知义务履行情况;采用SPSS23.0统计软件进行数据分析。结果 73.61%(106/144)的医师履行输血告知时间大于或等于5 min;能有效解答75.00%(108/144)患者的疑问;医师对各输血知情条目履行告知比例存在明显差异;34.72%(50/144)的医师履行输血告知义务较差(条目得分小于10分);科室、年龄、性别、专业技术职务、工作年限与医师履行输血告知义务无关,差异均无统计学意义(P>0.05);是否在临床接受输血培训是影响医师输血告知义务质量的独立相关因素(优势比=4.72,95%可信区间:1.71~13.02,P=0.003);临床医师在履行告知义务时对临床较为少见的输血方式或不常发生的输血风险告知较少,且对输血的替代治疗方案告知不全,超过一半的临床医师未告知受血患者输血后1年内不能献血。结论 临床医师履行输血告知义务质量尚有待于提高,针对性地开展系统培训有利于提高临床医师履行输血告知义务质量,从而有利于患者积极、主动地参与输血决策,以提高输血质量和安全性。
Objective To investigate the current status and related factors of clinicians in implementing blood transfusion notification obligations, in order to provide scientific basis for the formulation of measures to improve the quality of implementing the blood transfusion notification obligation.Methods Using the method of prevalence survey, a total of 144 clinicians who had received at least one red blood cell transfusion order from April 1 to June 30,2019 in a tertiary hospital were taken as the research objects, and the revised questionnaire about clinicians′ notification obligation of blood transfusion in British blood transfusion review was used as the survey tool, which mainly included the general situation of the research objects and the implementation of the notification obligations of 15 core blood transfusion items.The SPSS23.0 software was used for statistical analysis.Results 73.61%(106/144) clinicians had the time of implementing the notification of blood transfusion more than five minutes, which could effectively answer 75.00%(108/144) patients′ questions.There were significant differences in the proportion of clinicians′implementation of notification obligations of the blood transfusion items, among which 34.72%(50/144) clinicians had poor implementation of blood transfusion notification obligation(entries score less than 10 points).The department, age, gender, professional and technical position, and working years had nothing to do with clinicians′ notification obligation of blood transfusion, and the differences were not statistically significant(P>0.05).However, receiving transfusion training in clinical practice was an independent factor affecting the quality of transfusion notification obligation(OR=4.72,95%CI:1.71-13.02,P=0.003).When implementing the obligation of notification, clinicians rarely notifed the relatively rare blood transfusion methods or infrequent transfusion risks, and did not fully notify the alternative treatment plan of blood transfusion.More than half of clinicians did not notify the patients that they could not donate blood within one year after transfusion.Conclusion The quality of clinicians′ implementing part of the notification obligation blood transfusion needs to be improved.Targeted systematic training is conducive to improving the quality of clinicians′ implementation of the notification obligation blood transfusion, so that patients can actively participate in blood transfusion decision-making, so as to improve the quality and safety of blood transfusion.
作者
伍莉
张鹏
夏文军
文爱清
郑文红
何海燕
WU Li;ZHNAG Peng;XIA Wenjun;WEN Aiqing;ZHENG Wenhong;HE Haiyan(Nursing Department,Specialty medical center of the Third Military Medical University,Chongqing 400042,China;Department of critical medicine,Specialty medical center of the Third Military Medical University,Chongqing 400042,China;Department of Blood Transfusion,Specialty Medical center of the Third Military Medical University,Chongqing 400042,China;Vocational education center,Third Military Medical University,Chongqing 400042,China)
出处
《现代医药卫生》
2023年第2期275-279,共5页
Journal of Modern Medicine & Health
关键词
医师
输血
影响因素分析
调查和问卷
Clinician
Blood transfusion
Influence factors analysis
Surveys and questionnaires
作者简介
伍莉(1985-),本科,主管护师,主要从事危重患儿护理、人文护理管理、护理教学管理工作;通信作者:何海燕,E-mail:hehaiyan118@163.com。
