看護師による安全な静脈注射実施に向けた北海道大学病院での取組み : 静脈注射エキスパートナース育成を中心とした教育体制の構築

intravenous infusion

看護総合科学研究会誌

The Ministry of Health, Labour and Welfare in Japan adopted in 2002 a new legal interpretation that stated that nurses were able to practice intravenous infusions under physicians' orders. The Hokkaido University Hospital is an advanced treatment facility that employs state-of-the-art medical technology in its role as the healthcare hub in Hokkaido. There is a high likelihood that patients receiving cancer therapy at this hospital will require high-risk drugs administered by intravenous infusions. However, nurses' infusion safety practices were found to be less than optimal because approximately 30% of nurses had fewer than three years of experience. We therefore aimed to establish an educational system whereby nurses could acquire advanced knowledge and skills pertaining to safe intravenous infusions. Our hospital founded a special committee that reviewed infusions performed by nurses. The committee created facility-wide criteria that have promoted a concrete division of roles among health care professions. A session run by expert nurses resulted in the establishment of a unique system to educate nurses about intravenous infusions. All Nurses began performing the infusions in 2008. This study describes the process underlying the approach of the institution and the committee as well as the expert nurse session that combined special lectures, group work, and unit learning. We also describe possible limitations of the institutional approach and the educational system.