家庭自我管理干预应用于门急诊患儿外周静脉留置针维护的效果研究

目的探讨家庭自我管理干预应用于门急诊患儿外周静脉留置针维护的效果,寻求有效的干预措施,以降低门急诊患儿外周静脉留置针不良事件的发生率,延长其留置时间。方法便利抽样法选取2014年3—5月在湖南省儿童医院留观输液科使用外周静脉留置针的7382例患儿及其家庭设为对照组,采用常规方法维护静脉留置针;选取2016年3-5月的8071例患儿及其家庭设为观察组,采用家庭自我管理干预维护外周静脉留置针;比较两组患儿的外周静脉留置时间及不良事件的发生情况。结果对照组患儿外周静脉留置时间为(48.43±12.26)h,而观察组为(68.37±22.07)h,差异有统计学意义(t=1.57,P=0.007)。对照组患儿外周静脉留置后不良事件发生率为37.57%,观察组不良事件发生率为16.72%,两组在静脉炎、堵管、渗漏、意外拔管、压伤、及皮肤过敏等不良事件的发生情况比较,差异均有统计学意义(均P0.01)。结论家庭自我管理干预应用于门急诊患儿外周静脉留置针的维护,能降低其不良事件发生率,延长留置时间,减轻患儿痛苦,减轻护士工作量,节约医疗成本的同时产生一定的社会效益。

Study of the Effect of Family Self-management Intervention on Pediatric Intravenous Indwelling Needle Maintenance

Objective To explore the effect of family self-management intervention on the maintenance of peripheral vein indwelling needle in pediatric emergency department,and to find a good intervention to reduce the incidence of adverse events and prolong the indwelling time of peripheral blood in pediatric emergency department.Methods By convenience sampling,7382 children and their families with peripheral venous indwelling needle were selected as control group from in Hunan Province from March to May in 2014.The routine method was used to maintain the intravenous indwelling needle.From March to May,8071 children and their families from March to May in 2016 were selected as observation group.The patients were treated with family self-management intervention to maintain the peripheral vein indwelling needle.The retention time and the incidence of adverse events were compared between the two groups.Results The retention time of peripheral vein was (48.43±12.26) h in the control group and (68.37±22.07) h in the observation group,the difference was statistically significant (t=1.57,P=0.007).The incidence of adverse events in the control group was 37.57％.The incidence of adverse events in the observation group was 16.72 ％.The differences of incidence of adverse events such as phlebitis,obstruction,leakage,accidental extubation,crush and skin allergies were statistically significant (all P＜0.01).Conclusions The family self-management intervention can be used to maintain the incidence of adverse events,prolong the indwelling time,reduce the pain of children,reduce the workload of nurses and save the medical cost,and produce certain social benefits.