利用無痛性保膚膜降低非預期性小兒靜脈重注射率之護理專案

A Nursing Case Study on Using No Sting Barrier Films to Lower Incidental IV Recatheterization in Pediatric Patients

任瑋瑄(Wei-Hsuan Jen) ； 鍾詩琦(Shih-Chi Chung) ； 邢鴻君(Hung-Chun Hsing) ； 黃敏芳(Min-Fang Huang)

《長庚護理》 29卷3期 (2018/09) Pp. 367-379

https://doi.org/10.6386/CGN.201809_29(3).0004

摘要

本專案目的在降低非預期性小兒靜脈重注率以提升其護理品質。民國104年間，以病歷回溯方法調查兒科病房於民國103年6-8月間的小兒靜脈重注射之頻率並分析原因。結果發現小兒靜脈重注射率與固定膠布失去黏性、因注射部位潮溼、或炎症反應有關。經文獻查證後，選擇無痛性保膚膜為介入措施並修訂小兒靜脈注射流程。本專案在民國104年6-8月進行新措施之護理介入，並紀錄執行期間住院病童的靜脈重注射率與原因。專案實施後病房小兒靜脈重注射率從36.6%降至3.7%，不論是因注射部位潮溼或炎症反應所導致必須重注射的狀況都有明顯的改善。除此之外，護理作業中因小兒靜脈重注射額外增加的護理工時也從每次19.8分鐘降至10.7分鐘。在小兒靜脈重注射流程中增加無痛性保膚膜可以明顯改善小兒靜脈重注射的次數與降低不必要的護理工時。

關鍵字

無痛性保膚膜 ； 非預期性小兒靜脈重注射

並列摘要

This study improved nursing quality by lowering incidental IV recatheterization in pediatric patients. A retrospective medical record review was conducted in 2015 to examine the reasons behind the frequency of IV recatheterization in patients in a pediatric ward. The period examined was between June and August 2014. IV Recatheterization was found to be related to medical tapes losing adhesiveness, wet injection site, scratching activity (due to itchiness), and inflammatory reaction requiring catheter removal. Following a literature review, an intervention measure using no sting barrier films was adopted in IV catheterization for children and was implemented in June–August 2015. All incidents of and reasons for recatheterization in hospitalized pediatric patients were recorded during the intervention period. Incidence of recatheterization decreased from 36.6% to 3.7% following the intervention; in particular, such incidence attributable to wet injection site, scratching activity, and inflammatory reaction was substantially lowered. Furthermore, the additional time required by nursing professionals to conduct recatheterization decreased from 19.8 min to 10.7 min. Incorporating the use of no sting barrier film in IV catheterization procedures markedly reduced IV recatheterization incidence in pediatric patients and unnecessary nursing time.

並列關鍵字

no sting barrier film ； incidental IV recatheterization in pediatric patients

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