低价值护理项目临床使用现状调查
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女,硕士在读,学生

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国家自然科学基金青年项目(72104154)


A survey of clinical utilization status of low-value nursing care services
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    摘要:

    目的 了解低价值护理项目的临床使用现状,为相关部门采取针对性措施减少低价值护理服务、减少资源的浪费提供参考。方法 采用便利抽样法,对内科、外科、妇产科、儿科、急诊科和重症监护室16个病区384名临床护士进行问卷调查,了解37个低价值护理项目的临床使用频率,并分析各个项目使用频率的分布特征。结果 在调查的37个低价值护理项目中,12个项目(32.4%)的使用频率中位数≥30%,11个项目(29.7%)的使用频率中位数≥50%。25个低价值护理项目(67.6%)的使用频率分布特征为基本停用型,6个项目(16.2%)为常规使用型,2个项目(5.4%)为使用两极型,4个项目(10.8%)为尚无共识型。妊娠期糖尿病护理、约束与新生儿护理相关的项目使用频率的中位数分别为54.5%、51.1%、40.5%,分列前3位;静脉导管护理、尿管护理相关的项目使用频率最低,小于15.0%。结论 虽然67.6%的低价值护理项目在临床基本停用,但仍有32.4%的项目在临床实践中广泛或部分广泛使用。需针对临床使用频率较高的低价值护理项目,根据其使用频率的分布特征,采取针对性措施,以减少资源浪费,促进护理服务高质量发展。

    Abstract:

    Objective To understand the clinical utilization status of low-value nursing care, in order to provide a reference for relevant departments to take targeted measures to reduce low-value care services and minimize the waste of resources.Methods Using convenience sampling, a questionnaire survey of 384 clinical nurses in 16 wards of internal medicine, surgery, obstetrics and gynecology, pediatrics, emergency medicine, and intensive care unitwas conducted.The frequency of use of 37 low-value nursing care practices were investigated and the distributional characteristics of their frequency of use were analyzed.Results Twelve (32.4%)low-value nursing care practices had a medium of use ≥30%, and eleven (29.7%) low-value nursing care practices had a medium of use ≥50%.At the same time, the frequency of use of each item showed different distribution characteristics, of which twenty-five(67.6%) were characterized as "basically deactivated", six (16.2%) as "routinely used", two (5.4%) as "polarized", and four (10.8%) as "no consensus yet".The results of the comparison of the frequency of use of low-value care practices in different categories showed that the 50th percentile frequency of use of items related to gestational diabetes care, restraint care, and neonatal care were 54.5%, 51.1%, and 40.5%, respectively, which were the top 3; whereas the frequency of use of items related to intravenous catheterisation care and urinary catheterisation care was the lowest, at less than 15.0%.Conclusion This study showed that 67.6% of the low-value nursing care services were largely discontinued in clinical practices, while 32.4% were still widely or partially widely used. Targeted measures need to be taken for low-value care items with a high frequency of clinical use, based on the distribution characteristics of their frequency of use, in order to reduce the waste of resources and promote the high-quality deve-lopment of care services.

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关瑜山,茹楠,贾香平,李杰红,孟朝琳.低价值护理项目临床使用现状调查[J].护理学杂志,2025,(1):59-64

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  • 收稿日期:2024-07-23
  • 最后修改日期:2024-10-31
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  • 在线发布日期: 2025-02-10