长沙某院儿童静脉输液时输液管与针头分离的原因分析

Analysis of Causes of Separation of Infusion Tube and Needle during Intravenous Infusion in Children in a Hospital in Changsha

目的:分析长沙某院儿童静脉输液时输液管与针头分离的原因,探讨相应的对策,保障儿童输液安全。方法:回顾性选取2020年11月-2021年10月于长沙妇幼保健院门诊输液过程中发生输液管针头脱出输液瓶塞的400例患儿作为研究对象,收集患儿临床资料,分析输液管针头脱出输液瓶塞的原因。结果:400例患儿男236例(59.00%),女164例(41.00%);≤3岁311例(77.75%),4~7岁89例(22.25%);留置针输液122例(30.50%),非留置针输液278例(69.50%);输液部位在头部186例(46.50%),输液部位在手部195例(48.75%),输液部位在脚部19例(4.75%);发生于春季78例(19.50%),发生于夏季106例(26.50%),发生于秋季106例(26.50%),发生于冬季脱落110例(27.50%);输液第1天脱落170例(42.50%),输液第2天脱落162例(40.50%),输液第3、4天脱落68例(17.00%);输液时长0~30 min 177例(44.25%),输液时长31~60 min 145例(36.25%),输液时长>60 min 78例(19.50%)。400例患儿发生输液管与穿刺针头分离的主要原因为患儿玩耍拉扯、患儿哭吵躁动。不同性别、有无留置针患儿发生玩耍拉扯、哭吵躁动率比较,差异无统计学意义(P>0.05);≤3岁患儿发生玩耍拉扯、哭吵躁动率高于>3岁患儿,输液部位在手部时,患儿发生玩耍拉扯、哭吵躁动率高于输液部位在头部与脚部,输液季节在冬季时,患儿发生玩耍拉扯、哭吵躁动率高于其他季节,输液第1天,患儿发生玩耍拉扯、哭吵躁动率最高,输液时长31~60 min时,患儿最易发生玩耍拉扯、哭吵躁动,差异有统计学意义(P<0.05)。结论:长沙某院儿童静脉输液时输液管针头脱出输液瓶塞的主要原因为患儿玩耍拉扯、患儿哭吵躁动,此外还与患儿年龄、输液部位、输液季节、输液天次、输液时长有关,建议加强对患儿及家属的个性化健康教育,提供舒适的输液环境,以提高输液安全意识,保障儿童健康。

Objective:To analyze the reason of the separation of infusion tube and needle during intravenous infusion in a hospital of Changsha,and explore the corresponding countermeasures to ensure the safety of children's infusion.Methods:A retrospective study was conducted on four hundred cases of children with transfusion tube needle out of infusion bottle stopper during infusion in outpatient department of Changsha Maternal and Child Health Hospital from November 2020 to October 2021.The clinical data of the children were collected,and the causes of the needle out of the infusion bottle were analyzed.Results:Among the 400 children,236(59.00%)were males and 164(41.00%)were females;there were 311(77.75%)patients≤3 years old and 89(22.25%)patients 4-7 years old;there were 122 patients(30.50%)with indignant needle and 278 patients(69.50%)with non-indignant needle;the infusion site was in the head in 186 cases(46.50%),the hand in 195 cases(48.75%),and the foot in 19 cases(4.75%);occurred in 78 cases(19.50%)in spring,106 cases(26.50%)in summer,106 cases(26.50%)in autumn,and 110 cases(27.50%)in winter;there were 170 cases(42.50%)on the first day of infusion,149 cases(37.25%)on the second day,and 68 cases(17.00%)on the third and fourth day of infusion;infusion duration was 0-30 min in 177 cases(44.25%),30~60 min in 145 cases(36.25%),and longer than 60 min in 78 cases(19.50%);the main reasons for the separation of infusion tube and puncture needle in 400 children were children's play pulling,children's crying agitation;there was no significant difference in the proportion of children with different gender and with or without indwelling needle in playing and pulling,crying and agitation(P>0.05);the rate of play pulling,crying and agitation in children≤3 years old was higher than that in children>3 years old;when the infusion site was in the hand,the rate of playing and pulling,crying and agitation was higher than that in the head and feet;during the infusion season in winter,the rates of play,crying and agitation were higher than those in other seasons;on the first day of infusion,the children had the highest rate of play pulling,crying and agitation;when the infusion duration was 31-60 min,the children were most prone to play pulling,crying and agitation,and the difference was statistically significant(P<0.05).Conclusion:The main reasons for the needle of infusion tube to come out of the bottle stopper during intravenous infusion in children in a hospital in Changsha were children playing and pulling,children crying and agitation.In addition,it is also related to the age of children,infusion site,infusion season,infusion day and infusion duration.It is recommended to strengthen personalized health education for children and their families,and provide a comfortable infusion environment to improve transfusion safety awareness and protect children's health.