縮短極低體重早產兒入院體溫回升時間

Shortening Body Temperature Recovery Time of Hospitalized Premature Infants with a Very Low Birth Weight

陳秀湞(Hsiu-Chen Chen) ； 楊美玲(Mei-Ling Yang) ； 陳亞婕(Ya-Chien Chen)

《長庚護理》 28卷2期 (2017/06) Pp. 255-266

https://doi.org/10.3966/102673012017062802006

摘要

低體溫早產兒的死亡率是正常體溫者的3.64倍，本專案旨在縮短極低體重早產兒入院後體溫上升時間。專案實施前極低體重早產兒在入院後一小時體溫低於36℃為62.5%，分析原因為：①護理人員對於早產兒體溫調節認知低；②醫師執行侵入性處置時，在早產兒身體覆蓋乾冷不透光布單，阻隔輻射加溫；③床位上方有通風口等。本專案小組對極低體重早產兒入院後的升溫技巧提出改善措施：加強護理人員對早產兒體溫調節之認知的教育訓練及升溫技巧、改善升溫設備、修訂極低體重早產兒入院後體溫上升之標準作業並定期監測護理師執行體溫照護技術。經專案實施後，極低體重早產兒入院後一小時體溫低於36℃比率由62.5%降至3.3%，同時護理人員對影響極低體重早產兒體溫調節的認知正確率由46.2%提升至91.8%，顯現擬訂的改善措施有效。

關鍵字

低體溫 ； 極低體重早產兒 ； 體溫調節

並列摘要

The mortality rate of premature infants with hypothermia is 3.64 times higher than those with a normal temperature. This project aims to shorten the body temperature recovery time of premature infants with a very low birth weight at the time of hospitalization. Prior to the project implementation, 62.5% of the infants with a very low birth weight had the temperature of lower than 36℃ one hour after hospitalization. The reasons after analysis include: 1. The nurses' awareness of the premature infants' thermoregulation was low; 2. When the physicians performed invasive disposal, the infants were covered in a cold, dry, and opaque sheet, which blocked radiation heating; 3. There were vents above the bed. The project team proposed improvement measures for techniques to increase the temperature of infants with a very low birth weight after hospitalization, strengthened education training on the nurses' awareness of premature infant thermoregulation and warming techniques, improved warming equipment, revise the standard operations for premature infants' temperature rise after hospitalization, and regularly monitor nurses' thermocare techniques. After the project implementation, the proportion of the premature infants with a very low birth weight whose temperature was below 36℃ one hour after hospitalization dropped from 62.5% to 3.3%. At the same time, the accuracy of caregivers' awareness of the premature infants' thermoregulation increased from 46.2% to 91.8%, indicating the improvement measures formulated are indeed effective.

並列關鍵字

hypothermia ； VLBW infant ； thermoregulation

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