提升新生兒加護病房早產兒寧握護理執行率之專案

The program to raise execution rates of containment care for preterm infants in neonatal intensive care unit

沈鳳珠(Shen-Feng Chu) ； 盧靖雯(Lu-Chin Wen) ； 邱曉彤(Chiu-HsiaoTung)

《安泰醫護雜誌》 22卷2期 (2016/12) Pp. 16-27

摘要

目的：此專案為提升護理人員寧握護理執行率，以降低早產兒的疼痛指數。方法：針對妊娠28週至36週使用呼吸器之20位早產兒，出生體重1000-2000公克，執行氣管內管抽痰達135次，藉由寧握護理，以早產兒疼痛評估量表Premature Infant Pain Profile(PIPP)進行疼痛評估以降低早產兒於氣管內管抽痰時之疼痛指數。結果：實施後，護理人員評量成績由70分提升至90分，寧握護理執行率由21%提升至39%，疼痛指數由中度疼痛9分降至輕度疼痛5分。結論：採一致性的疼痛評估工具及寧握執行標準流程，以提升寧握執行率，進而減輕疼痛指數。早產兒在抽痰過程中，呼吸、心跳及血氧濃度等生命徵象皆能呈現穩定狀態，促進行為穩定，提早脫離呼吸器使用時間，進而縮短護理人員照護天數，增加早產兒安全感，提升早產兒住院期間的舒適性及照護的完整性。

關鍵字

寧握護理 ； 氣管內管抽痰 ； 疼痛指數

並列摘要

Purpose: The aim of this study is to lower the pain scores of preterm infants via improvement of nursing containment care. Methods: Twenty preterm infants with gestational age 28-32 weeks, birth body weight 1000-2000gm and under went 135 times of endotracheal suction were evaluated using the premature infant pain profile (PIPP) to pain scores after accepting endotracheal suction. Outcomes: Improvement of nursing containment care, increased the score of nursing assessment from 70 points to 90 points and execution rates from 21 to 39 percent. Furthermore the pain scores of premature infan reduced from moderate pain 9 points to mild pain 5 paints. Conclusions: Standard evaluation tools were used according to protocol with the raise in execution rates for containment care, the pain scores of premature infans improved. While the premature infans undenwent sputum suction, thein vital signs were stable, behavion, the success towean offventilators were more likely and therefore minimizes the number of hospital stays for nursing care. The overall quality care of premature infans improvd profoundly.

並列關鍵字

containment care ； endo suction ； pain rate