内容紹介
Summary
Our hospital has an established outpatient chemotherapy room, and medical doctors have accessed veins for infusion so far. We trialed venous access by nurses for the purpose of managing safe and proper cancer chemotherapy, reducing the work of doctors, and reducing patient waiting time. A questionnaire was conducted in June 2013, and nurses secured routes at 19 facilities(58%)of the 33 national university hospitals. In November of the same year, the working group was established, and from September 2016 to March 2017, lectures, practical skills, a paper test, and a practical test were conducted; successful applicants were approved as in-hospital certified nurses. From April 2017, we started intravenous injection of anti-cancer drugs by nurses in outpatient chemotherapy rooms and always waiting for doctor in chemotherapy room. There have been many favorable reports of reduced pain and less route failure from patients, and issues, such as extravasation and dyspnea, have not occurred yet. The doctors who were interrupting their work by 29 minutes(20 minutes to and from the patient for a 9-minute procedure)could concentrate on their own tasks. However, patient waiting time increased from 14 minutes to 21 minutes because the amount of work for nurses increased. In the future, reducing the burden on nurses, for example, by increasing the number of nurses, is warranted.
要旨
当院は2007年に外来化学療法室を開設し,これまで抗がん剤ルート確保は医師が行ってきた。安全で適正ながん化学療法の管理,医師の業務軽減,患者の待ち時間短縮を目的として看護師による抗がん剤ルート確保実施に向けて取り組んだ。2013年6月にアンケートを行い,国立大学病院33施設中19施設(58%)で看護師がルート確保を行っていた。同年11月にワーキンググループを立ち上げ,2016年9月～2017年3月に講義,実技,ペーパーテスト,実技テストを行い,合格者を院内認定看護師として承認した。2017年4月から外来化学療法室において,看護師による抗がん剤の静脈注射と外来化学療法室での医師待機を開始した。患者からは痛みや失敗が少ないと好意的な意見が多く,血管外漏出や穿刺困難などのトラブルも起こっていない。29分(往復20分,滞在9分)業務を中断していた医師は業務へ集中できるようになった。一方で,看護師業務が増え,患者待ち時間は14分から21分へむしろ延長した。今後は看護師増員など看護師の負担軽減が課題となっている。
目次
Our hospital has an established outpatient chemotherapy room, and medical doctors have accessed veins for infusion so far. We trialed venous access by nurses for the purpose of managing safe and proper cancer chemotherapy, reducing the work of doctors, and reducing patient waiting time. A questionnaire was conducted in June 2013, and nurses secured routes at 19 facilities(58%)of the 33 national university hospitals. In November of the same year, the working group was established, and from September 2016 to March 2017, lectures, practical skills, a paper test, and a practical test were conducted; successful applicants were approved as in-hospital certified nurses. From April 2017, we started intravenous injection of anti-cancer drugs by nurses in outpatient chemotherapy rooms and always waiting for doctor in chemotherapy room. There have been many favorable reports of reduced pain and less route failure from patients, and issues, such as extravasation and dyspnea, have not occurred yet. The doctors who were interrupting their work by 29 minutes(20 minutes to and from the patient for a 9-minute procedure)could concentrate on their own tasks. However, patient waiting time increased from 14 minutes to 21 minutes because the amount of work for nurses increased. In the future, reducing the burden on nurses, for example, by increasing the number of nurses, is warranted.
要旨
当院は2007年に外来化学療法室を開設し,これまで抗がん剤ルート確保は医師が行ってきた。安全で適正ながん化学療法の管理,医師の業務軽減,患者の待ち時間短縮を目的として看護師による抗がん剤ルート確保実施に向けて取り組んだ。2013年6月にアンケートを行い,国立大学病院33施設中19施設(58%)で看護師がルート確保を行っていた。同年11月にワーキンググループを立ち上げ,2016年9月～2017年3月に講義,実技,ペーパーテスト,実技テストを行い,合格者を院内認定看護師として承認した。2017年4月から外来化学療法室において,看護師による抗がん剤の静脈注射と外来化学療法室での医師待機を開始した。患者からは痛みや失敗が少ないと好意的な意見が多く,血管外漏出や穿刺困難などのトラブルも起こっていない。29分(往復20分,滞在9分)業務を中断していた医師は業務へ集中できるようになった。一方で,看護師業務が増え,患者待ち時間は14分から21分へむしろ延長した。今後は看護師増員など看護師の負担軽減が課題となっている。