儿科患者外周静脉输液管理的临床过程及结果评价

Clinical Processe of Peripheral Intravenous Infusion and its Outcome Assessment

目的评估和监测儿科患者外周静脉输液管理的临床过程和结果。方法采用美国波士顿儿童医院设计的“静脉输液临床过程及结果监测”作为评价工具,对102位外周静脉输液患儿的静脉输液过程和结果进行监测。并对评价工具采用了回翻技术和表面效度的测定。收集资料的方法包括询问家长、观察输液部位、审核护理记录。结果第1次穿刺成功率为68.5%,注射部位的安全性达98.3%,每小时护士巡回率达100%。而通过敷贴能观察到进针部位仅为7.8%;仅8.82%的病史记录能反映护士对注射部位的观察及注射部位的状况;静脉外渗发生率为60.78%,其中74.2%为I度静脉外渗。结论静脉输液管理的护理记录、敷料的护理、外周静脉通路的选择等方面需要改善。

Objective To assess the clinical process of peripheral intravenous （Ⅳ） infusion and its outcomes. Methods ＂Peripheral Ⅳ clinical process and outcomes mon. itor＂ questionnaire designed by Boston Children＇s Hospital was employed in 102 children receiving Ⅳ infusion. Back translation technique was used and face validity was conducted for the instrumentation. The data of 102 patients were collected through parents interview, peripheral Ⅳ injection site Observation, and nursing documentation reviewing. Results The successful rate of first puncturing was 68.5%. The safe rate of injection site was 98.3%. During Ⅳ injection, the visiting rate of nurses was 100%. Only 7.8% of Ⅳ dressing allowed visualization of insertion site and onty 8.82% of the documentations showed that the nurses have checked the Ⅳ sites at the beginning of each shift. The rate of venous infiltration was 60.78%;74.2% of the infiltration cases were of stage Ⅰ. Conclusion The nursing documentation of peripheral Ⅳ infusion management, Ⅳ dressing, and the selection of venous pathway of chemotherapy need to be improved during peripheral intravenous infusion.