基于前馈控制的护理措施对新生儿静脉输液外渗风险因素的预防研究

Preventive study of nursing measures based on feedforward control on risk factors of neonatal intravenous infusion extravasation

目的研究基于前馈控制的护理措施对新生儿静脉输液外渗风险的预防作用。方法选取广东省妇幼保健院新生儿科于2020年2月至2021年2月收治的214例行静脉输液治疗的足月新生儿进行研究,按随机数表法分为观察组和对照组各107例。对照组新生儿给予常规输液护理,观察组新生儿给予基于前馈控制的输液护理。护理15 d后,比较两组新生儿护理后静脉输液外渗情况、静脉输液外渗状况护理人员主动上报情况及家属对护理满意度,采用多因素Logistic回归分析法分析新生儿静脉输液渗出与外渗的风险因素。结果护理后,观察组新生儿静脉输液外渗发生率为6.54%,明显低于对照组的14.95%,差异具有统计学意义(P<0.05);护理后,观察组新生儿2、3、4级外渗程度发生率分别为36.45%、13.08%、3.74%,明显低于对照组的51.40%、24.30%、14.95%,差异均具有统计学意义(P<0.05);观察组新生儿静脉输液外渗状况护理人员主动上报率为92.52%,明显高于对照组的74.77%,差异具有统计学意义(P<0.05);护理后,观察组家属护理满意度为95.33%,明显高于对照组的83.18%,差异有统计学意义(P<0.05);多因素Logistic回归分析结果显示,血管弹性、置管材质、输注药物、置管部位、穿刺护理人员工作年限与新生儿静脉输液外渗有关,是导致新生儿静脉输液外渗的危险因素(P<0.05)。结论基于前馈控制的护理措施对风险因素具有一定预防作用,不仅能有效降低新生儿静脉输液外渗率,减轻外渗发生程度,保证新生儿用药安全,还能明显提高护理人员对外渗发生情况的上报率,提高家属满意度。

Objective To study the preventive effect of nursing measures based on feedforward control on risk factors of intravenous infusion extravasation among newborns.Methods A total of 214 full-term newborns who received intravenous infusion therapy and were admitted to the Department of Neonatal Pediatrics in Guangdong Maternal and Child Health Care Hospital from February 2020 to February 2021 were selected for the study.According to the random number table method,the patients were divided into an observation group and a control group,with 107 patients in each group.The newborns in the control group were given routine infusion care,and those in the observation group were given infusion care based on feedforward control.After 15 days of nursing care,newborns’intravenous infusion extravasation,the nursing staff’s actively report of the situation,family’s satisfaction to nursing were observed and compared between the two groups.Multivariate logistic regression analysis was used to analyze the risk factors of neonatal intravenous infusion leakage and extravasation.Results After nursing,the incidence of intravenous infusion extravasation in the observation group was 6.54%,which was significantly lower than 14.95%in the control group(P<0.05).After nursing,the incidence of grade 2,3,and 4 extravasation in the observation group were 36.45%,13.08%,and 3.74%,which were significantly lower than 51.40%,24.30%,and 14.95%in the control group(P<0.05).Nursing staff actively reported 92.52%of intravenous fluid extravasation in the observation group,which was significantly higher than 74.77%in the control group(P<0.05).After nursing,the satisfaction of family members to nursing in the observation group was95.33%,which was significantly higher than 83.18%in the control group(P<0.05).Multivariate logistic regression analysis showed that vascular elasticity,catheter material,infusion drugs,catheter location,and puncture nursing staff’s working years were related to neonatal intravenous infusion extravasation,which were risk factors for neonatal intravenous infusion extravasation(P<0.05).Conclusion Nursing measures based on feedforward control has a certain preventive effect on risk factors.It can not only effectively reduce the rate of neonatal intravenous extravasation,reduce the degree of extravasation,and ensure the safety of medication for newborns,but also significantly increase the reporting rate of nurses’extravasation occurrence and improve the degree of satisfaction.