头孢菌素皮内过敏试验操作流程的改进

摘要

Objective To explore the application effect of operational process within improved cephalosporin intrader-mal allergy test ("skin test" for short). Methods 8756 patients with cephalosporin skin test at Department of Transfu-sion Room in Central Hospital of Jingzhou City (“our hospital”for short) from February 2011 to September 2012 were selected as control group, with Jiang Anli 2006 version of undergraduate nursing teaching materials of the editor of the New Basic Nursing Operation Process of cephalosporin skin test to do skin test. 9000 patients in our department during October 2012 to May 2014 in cephalosporin skin test were selected as observation group, the improved cephalosporin skin test procedures do skin test was applied. The improved process with nursing teaching material contrast, from skin test liquid preparation, skin test operation skin clean, skin test needle into the direction and angle, skin test injection quantity, skin test related health education, skin test result judgment time six aspects to improve, nurse training within the department and effective implementation. Cephalosporin skin test positive rate, rate of pain and skin test success rate of operation between two groups were observed. Results Skin test positive rate of control group was 9.9% (865/8756), pain rate of control was 19.6%(1720/8756), skin test operation success rate of control was 97.4% (8531/8756);skin test positive rate of observation group was 5.0% (446/9000), pain rate of observation group was 10.6% (953/9000), skin test operation success rate of observation group was 99.4% (8942/9000);there were highly statistical difference be-tween two groups (all P< 0.01). Nurses had completed skin test technology, fast accurate did skin test to reduce the patients pain and improved the success rate of skin test, skin test to determine accuracy and work efficiency, prevented the double sulfur reaction. Conclusion Cephalosporin skin test can improve the operation process and clinical nursing work closely with stronger practicability; reflect the concept taking patients as the center of the humanized nursing, pa-tients satisfaction; improve the skin test judgment accuracy, reduce the patients pain and burden; prevent and decrease the medical safety hidden trouble and disputes, im-prove the nursing quality.%目的：探讨改进后头孢菌素皮内过敏试验(以下简称“皮试”)操作流程的应用效果。方法选择2011年2月~2012年9月在湖北省荆州市中心医院输液室(以下简称“我科”)行头孢菌素皮试的8756例的患者作为对照组，以姜安丽主编的2006年版的本科护理学教材《新编护理学基础》的头孢菌素皮试操作流程做皮试；选择2012年10月~2014年5月在我科行头孢菌素皮试的患者9000例作为观察组，采用改进后头孢菌素皮试操作流程做皮试；改进后流程以护理教材作对照，从皮试液配制、皮试操作时皮肤清洁问题、皮试进针方向与角度、皮试注射液量、皮试相关健康教育、皮试结果判断时间六个方面进行改进，对科内护士进行培训并有效实施。观察两组头孢菌素皮试阳性率、疼痛率及皮试一次操作成功率。结果对照组皮试阳性率为9.9%(865/8756)，疼痛率为19.6%(1720/8756)，皮试一次操作成功率为97.4%(8531/8756)；观察组皮试阳性率为5.0%(446/9000)，疼痛率为10.6%(953/9000)，皮试一次操作成功率为99.4%(8942/9000)；两组比较差异均有高度统计学意义(均P<0.01)。护士能快速准确完成皮试液配制，提高了皮试判断准确度及工作效率，防范了双硫仑样反应的发生。结论改进后的头孢菌素皮试操作流程与临床护理工作紧密结合，实用性更强；体现了以患者为中心的人性化护理理念，患者满意度提升；提高了皮试判断准确率，减轻了患者痛苦与负担；防范与减少了医疗安全隐患及纠纷发生，提升了护理工作质量。