降低新生兒加護病房早產兒低體溫發生率

Reducing the Incidence of Hypothermia in Preterm Infants in Neonatal Intensive Care Units

黃美惠(Mei-Hui Huang) ； 顏雅婷(Ya-Ting Yen) ； 蔡郁婷(Yu-Ting Tsai) ； 陳惠鈴(Hui-Lin Chen)

《榮總護理》 37卷1期 (2020/03) Pp. 25-33

https://doi.org/10.6142/VGHN.202003_37(1).0003

摘要

本專案主旨為降低早產兒低體溫發生，早產兒若發生體溫低於36℃，死亡率增加高達64%，且因早產兒低體溫的問題常引起產兒醫護間指責與抱怨，故引發專案改善動機。2017年本單位發生早產兒低體溫比率高達54.5%。故成立本專案小組，現況調查後歸納原因包括缺乏醫護人員對新生早產兒體溫保護（含轉送）作業規範、缺乏早產兒低體溫教育訓練（含護理師、醫師）、醫療用品未加溫直接用於早產兒治療上、執行侵入性治療時保暖措施不足、未使用加溫保暖設備運送共5項。於參閱文獻及專家諮詢後，提出解決辦法為制定醫護人員對早產兒體溫保護（含轉送）作業規範、舉辦早產兒低體溫照護相關在職教育課程、製作保暖用品、增設加溫後的無菌用品及溫熱保暖設備。專案介入後單位早產兒低體溫比率由54.5%降至23.8%。藉由專案實施改善新生早產兒低體溫之風險，同時穩定早產兒後續治療過程，建議定期舉辦相關照護議題研習營，讓大家分享照護經驗，提升照護品質。

關鍵字

新生兒加護病房 ； 早產兒 ； 低體溫

並列摘要

The purpose of this project was to reduce the incidence of hypothermia in premature infants. If the body temperature of premature infants is lower than 36℃ , the mortality rate increases by as much as 64%. The problem of hypothermia in premature infants often results in accusations and complaints against nursing homes. In 2017, low body temperature was reported in 54% of premature infants in neonatal care units. Therefore, this study was conducted to reduce the incidence of hypothermia in preterm infants. The causes for such incidence are summarized as follows: First, the lack of standard practices for thermal protection of premature infants; second, the lack of education and training (including doctors and nurses) related to thermal protection of premature infants; third, the lack of preheated medical equipment; fourth, the insufficient body temperature maintenance measures during invasive procedures; and fifth, the lack of the use of preheated equipment when transferring. After reviewing literature and consulting experts, we proposed a solution for medical care of premature infants, body temperature protection (including transfer) operation specifications, holding care-related educational courses, production of warm supplies, use of warm sterile products, and warm heating equipment. Since the implementation of the project, the rate of hypothermia in premature infants has decreased from 54.5% to 23.8%. The project was implemented to reduce the risk of hypothermia in premature infants and stabilize the follow-up treatment process of premature infants. Regular training workshops should be conducted on infant care-related problems, and experiences should be shared to improve the quality of care.

並列關鍵字

neonatal intensive care unit ； premature infant ； hypothermia

參考文獻

李心慈、吳叔真、簡素真(2015)．降低自然產高危險性早產兒低體溫發生率之專案．彰化護理，22(2)，10-18。

林育嫺、杜明勳(2006)．低體溫的診斷及治療．基層醫學，21 (6)，139-144。

胡常麗、張曉梅、黃育鐸、李夢英、石惠美、吳寶媛(2016)．恢復室轉送員執行術後病人轉送安全之改善專案．長庚護理，27 (3)，377-390。

陳秀湞、楊美玲、陳亞婕(2017)．縮短極低體重早產兒入院體溫回升時間．長庚護理，28 (2)，255-266。

黃尹蓉、林思伶、陳秀玲(2019)．降低外傷科病房病人轉送前準備作業異常率之專案．新台北理期刊，21 (1)，59-74。