传染病科静脉留置针的横断面调查及护理对策

Cross-sectional survey and nursing countermeasures of intravenous indwelling needles in infectious diseases

目的调查并分析本院传染病科静脉留置针使用状况及存在问题。方法选择2018年5月30日09:00～10:00我院12个收治传染性疾病科室共240例静脉输液治疗的患者作为调查对象,调查静脉留置针应用情况、存在问题并提出相应护理对策。结果本研究240例静脉输液患者中,钢针使用例数181例(75.42%),其中输注强刺激性药物1例(0.6%)、4 h以上补液6例(3.3%)。使用静脉留置针输液患者59例(24.58%),其中使用密闭式12例(20.3%)、防针刺伤3例(5.1%),防堵管44例(74.6%);关节穿刺或下肢穿刺3例(5.1%);留置针维护固定欠妥43例(72.9%);输液接头连接不当1例(1.7%);再次使用前导管评估38例(64.4%);不同药物输注中冲管17例(28.8%);使用完毕未封管4例(6.78%)。临床护理应强化穿刺操作规程、输液护理、正确封管、妥善固定留置针及患者护理知识教育。结论我院传染性疾病科室需加强留置针推广,规范护理人员穿刺知识及操作技能培训,不断提高静脉穿刺临床护理水平及留置针输液安全性。

Objective To investigate and analyze the use status and existing problems of intravenous indwelling needles in our hospital.Methods 240 patients of intravenous infusion in 12 departments of infectious diseases from 09:00 to 10:00 on May 30,2018 were investigated as subjects.The application of intravenous indwelling needles was investigated,and problems existed and corresponding nursing countermeasures were proposed.Results Of the 240 patients with intravenous infusion,181(75.42%)used steel needles for treatment,including 1 case(0.6%)with infusion of strong stimulant drugs and 6 cases(3.3%)with rehydration for 4 hours or more.59 patients(24.58%)were treated with intravenous indwelling needles,including 12 cases(20.3%)with closed type,3 cases(5.1%)with anti-needle stab,and 44 cases(74.6%)with anti-blocking tube,3 cases of joint puncture or lower extremity puncture(5.1%),indwelling needle maintenance fixed not suitable in 43 cases(72.9%),infusion connector improperly connected in 1 case(1.7%),38 cases of catheter evaluation before re-use(64.4%),17 cases of flushing in different drug infusion(28.8%);4 cases(6.78%)without sealing after use.The puncture operation procedures,infusion care,correct sealing,proper fixation of indwelling needles and patient care knowledge education should be strengthened in clinical nursing.Conclusion The infectious disease department of our hospital needs to strengthen the promotion of indwelling needles,standardize the puncture knowledge and operation skill training of nursing staff,and continuously improve the clinical nursing level of venipuncture and the safety of indwelling needle infusion.