Construction And Application Research Of Standard System For Intravenous Chemotherapy Administration For Cancer

Objective: The aim of this thesis is to construct a set of standard system for intravenous chemotherapy drug use in cancer,which covers the whole process of chemotherapy medication usage and is shared by medical-pharmacological-nursing multidisciplinary interoperability,and gives standardized requirements for drug use staff,drug use environment,drug use process,monitoring and follow-up,etc,and provides support for achieving homogeneous management of intravenous chemotherapy in cancer and protecting patient safety.According to the standard system,we investigate the current situation of intravenous chemotherapy drug use in Sichuan Province,and further verify the scientificity and feasibility of the standard,so as to provide a basis for the promotion and application of the standard.Methods:（1）Guided by the Wuli-Shili-Renli system methodology,the preliminary draft of intravenous chemotherapy standard system for tumor is formulated by literature review,the expert consultation draft is formed by the expert meeting method,and the final draft of the standard system is derived by the delphi method.The indexes of entry revision included positive coefficient,authority coefficient,variation coefficient,Kendall’s coordination coefficient,high recognition rate and experts’ opinions.（2）A cross-sectional study is conducted to investigate the current status of implementation of the standard system for chemotherapy drug use,and to evaluate the scientificity and accessibility of the standard system using a cluster sampling of medical staff engaged in chemotherapy in Sichuan Province.Results:（1）After three rounds of expert consultation,this thesis finally formes a standard system of tumor intravenous chemotherapy drug use consisting of 4 first-level items,14 second-level items,47 third-level items and 36 items descriptions.Including the qualification and continuing education requirements of chemotherapy drug use staff,environmental requirements for chemotherapy drug preparation,transport,warning labeling,information system,chemotherapy administrations and monitoring and followup standardized operational requirements and so on.（2）The feedback rate of three rounds of expert consultation is 100%.The expert authority coefficients of the three rounds are0.895,0.890 and 0.885 respectively.The importance coordination coefficients of items are 0.350,0.121 and 0.143 respectively.The operability coordination coefficients of items at the third-level items is 0.190（P < 0.05）,and coefficient of variation of all items are <25%,and the average high recognition rate is 96% respectively.The recognition of all items by experts is consistent.（3）The average score of implementation of intravenous chemotherapy drug standards in Sichuan province is 117.01±17.87,and the average score rate is 83.6%.The average scoring rates of the four dimensions is 87.4% in process standard,84.8% in monitoring and follow-up standard,68.1% in staff standard and 57.5%in environmental standard.Conclusion: The standard system of intravenous chemotherapy for tumor established in this thesis is scientific and operable,and can provide basis for the management and standardized operation for clinical chemotherapy medication staff,environment,process,monitoring and follow-up.Although tumor chemotherapy is widely carried out in Sichuan province,the homogeneity of medication staff qualification administration,medication environment,medication process,monitoring and follow-up needs to be further improved,especially medication environment and staff qualification.The high consistency between the expert consultation and the investigation results verifies that the standard is scientific and feasible.