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題名:兒科病房非計劃性靜脈重注改善專案
書刊名:長庚護理
作者:鄭瑜芬洪嘉玟陳雲絹黃珊
作者(外文):Cheng, Yu-fenHung, Chia-wenChen, Yun-chuanHuang, Shan
出版日期:2005
卷期:16:1=49
頁次:頁84-94
主題關鍵詞:兒科病童非計劃性靜脈重注局部腫脹輸液導管阻塞Pediatric patientsUnplanned re-catheterization intravenous injectionLocal swellingObstruction of transporting tube
原始連結:連回原系統網址new window
相關次數:
  • 被引用次數被引用次數:期刊(6) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:6
  • 共同引用共同引用:1
  • 點閱點閱:121
     週邊靜脈輸液治療是住院病童最常遇到之醫療措施,亦是病童住院中的主要壓力源之一。多數病童缺乏自我照顧能力,在其輸液過程中,若照顧者或護理人員未提供妥善照護,則易發生導管阻塞、浸潤等問題,致必須重新注射。本專案目的在降低兒科病房非計劃性靜脈重注率。筆者針對兒童內科病房中接受靜脈輸液治療之病童,探討其接受非計劃性靜脈重注之原因,結果發現主要原因為局部腫脹及輸液導管阻塞;而分析局部腫脹導因以注射處吸收不良及藥物滲漏為主,導管阻塞導因則以接頭鬆脫及未注意點滴瓶高度等造成回血凝固為最多,以上因素除導致病童須再次接受靜脈注射,亦造成護理工時及醫材之耗損。本專案藉由:人員在職教育、改善注射部位固定方式、製作「點滴注射叮嚀小卡」、制定監控機制等方案進行改善,結果顯示靜脈重注率由原22.5%降低為5.8%,護理工時每週由1540.35分鐘降低為1149.15分鐘,醫材耗費每週亦由7371元減少至1872元。本專案改善具顯著成效,提高護理照顧品質與降低成本,可作為兒科臨床護理之參考。
     The purpose of this project was to reduce unplanned re-catheterization intravenous injection. Factors associated with re-catheterization intravenous therapy were identified, including local swelling of an insert site and obstruction of a transporting tube. The major causes associated with local swelling of an insertion site were insufficient absorption of the fluid and medication leakage within the insertion site. The components associated with the obstruction of the transporting tube were due to displacement of a connector and inappropriate distance from the insertion site to the IV (intravenous) bottle. All these factors resulted in increasing nursing efforts and wasting the medical materials. Thus, a continuous nursing education in relation to intravenous injection was designed and applied. An IV caution card was hanged on the IV bottle. The results revealed a decrease in the re-catheterization rate from 22.5% to 5.8%. In additioin, both nursing workload and expurgate medical material were reduced. The results of this study presented an improving of re-catheterization of intravenous injection, and improving quality of nursing.
期刊論文
1.申寶苓(19990300)。各種品質提昇活動的探討。中華工商專校學報,18,72-90。  延伸查詢new window
2.黃樹樺、黃高彬(19981000)。周邊靜脈注射感染之預防與護理。院內感染控制雜誌,8(5),675-678。  延伸查詢new window
3.蔡淑芬(19981200)。靜脈注射常見的問題與處理。護理新象,8(4)=52,40-45。  延伸查詢new window
4.Lou, A. M.、Kirsten, H.、Kris, K.、Angela, O.、Tami, B.、Bettina, H.(1999)。Guideline for IV infiltrations in pediatric patients。Pediatric Nursing,25(2),167-180。  new window
5.Lamb, J.(1993)。Peripheral IV therapy。Nursing Standard,26(7),31-36。  new window
6.Magdziak, B. J.(1988)。There'€™s just no excuse for iv complication。RN,51(2),30-31。  new window
7.張翠樺、吳昭瑢(19990600)。非計劃性靜脈重注持續品質改進專案。護理雜誌,46(3),39-46。new window  延伸查詢new window
圖書
1.李僕良(1995)。全面品管的秘訣。台北:箴言企管。  延伸查詢new window
2.長庚醫院護理(2001)。靜脈灌注工作規範。台北:長庚紀念醫院。  延伸查詢new window
3.馬偕紀念醫院(2002)。靜脈注射護理。台北:馬偕紀念醫院。  延伸查詢new window
4.盧美秀(1990)。臨床醫護手冊。台北:華杏。  延伸查詢new window
5.Harald, S.、Bernd, J.、Barry M. F.(1997)。Catheterrelated infections。New York:Marcel Dekker。  new window
6.馬偕紀念醫院(1999)。靜脈注射護理。台北:馬偕紀念醫院。  延伸查詢new window
其他
1.楊惠智,楊慧珍(2004)。內外科創意文章,http://www.shk.org.tw/nurse, 2004/04/01。  延伸查詢new window
圖書論文
1.陳月枝、蔡秉琴、李雅玲、袁大錦、紀瑩、孫明華(1998)。護理措施在兒科之應用。小兒科護理學。台北:華杏。  延伸查詢new window
 
 
 
 
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