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护士在三级儿科保健中心进行外周静脉导管插入术的知识和经验。

Nurses' knowledge and experiences of peripheral intravenous catheter insertion at a tertiary paediatric health centre.

机构信息

Registered Nurse, Division of Pediatric Infectious Disease, Dr Behcet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Izmir, Türkiye.

Professor, Nursing Department, Health Sciences Faculty, Izmir Katip Celebi University, Izmir, Türkiye.

出版信息

Br J Nurs. 2022 Jul 21;31(14):S18-S25. doi: 10.12968/bjon.2022.31.14.S18.

Abstract

AIM

The aim of the study was to determine paediatric nurses' knowledge and experiences of PIVC insertion.

METHOD

In this cross-sectional study, nurses working in a paediatric hospital in Izmir, Türkiye, between May and September 2019 were included (225; 67.4%). A PIVC knowledge and experience form, and a sociodemographic characteristics questionnaire were used to collect data.

RESULTS

Nurses most often inserted the PIVC on the dorsum of the hand (83.1%). Their choice of vein was influenced by the condition of the patient's veins (91.1%), medications (72%) and the patient's activity status (70.2%). The most preferred PIVC size was 24 gauge (98.2%), and the most frequently used cannula was a short peripheral cannula (96.9%). To clean the insertion site of the cannula, 93.8% of the nurses used 70% alcohol. Distractions used while inserting the PIVC were: letting the child play with a toy (51.1%), having the child sit on the mother's lap (45.8%), letting the child watch cartoons (45.3%), and administering oral sucrose (43.6%). Of the nurses, 69.3% attached a split septum/vein valve to the PIVC insertion site, and 82.2% cleaned the split septum/vein valve with 70% alcohol and waited until it dried before administering the medication. Some 79.6% secured the cannula with a hypoallergenic nonwoven adhesive fixation tape bandage. Some 94.7% performed catheter flushing for control after inserting PIVCs, 93.8% performed catheter flushing before IV fluid treatment, 89.8% flushed the catheter before drug administration through the bolus method, 53.3% flushed the PIVC catheter with a slow technique and 42.2% flushed it with an intermittent technique.

CONCLUSION

The nurses generally acted in accordance with Infusion Nurses Society (2016) guidance. It would be helpful if the hospital developed algorithms that include standards to prevent and manage PIVC insertions and complications.

摘要

目的

本研究旨在确定儿科护士在经外周静脉置入中心静脉导管(PIVC)置管方面的知识和经验。

方法

本横断面研究纳入了 2019 年 5 月至 9 月在土耳其伊兹密尔一家儿科医院工作的护士(225 名;67.4%)。采用 PIVC 知识和经验表以及社会人口学特征问卷收集数据。

结果

护士最常在手背部进行 PIVC 置管(83.1%)。他们选择静脉的依据是患者静脉状况(91.1%)、药物(72%)和患者活动状态(70.2%)。最优选的 PIVC 规格是 24 号(98.2%),最常使用的套管是短外周套管(96.9%)。93.8%的护士在套管插入部位使用 70%酒精进行清洁。在插入 PIVC 时使用的分散注意力的方法包括:让孩子玩玩具(51.1%)、让孩子坐在母亲腿上(45.8%)、让孩子看动画片(45.3%)和给予口服蔗糖(43.6%)。69.3%的护士在 PIVC 置管部位接上分体式隔膜/静脉瓣,82.2%用 70%酒精清洁分体式隔膜/静脉瓣,待其干燥后再给药。约 79.6%的护士使用低敏非织造布 adhesive 固定带固定套管。约 94.7%的护士在插入 PIVC 后进行导管冲洗以控制,93.8%在进行静脉输液治疗前进行导管冲洗,89.8%通过推注法在给药前冲洗导管,53.3%缓慢冲洗 PIVC 导管,42.2%间歇冲洗。

结论

护士的行为总体上符合输液治疗学会(2016 年)的指南。如果医院制定包括预防和管理 PIVC 置管和并发症标准的算法,将会有所帮助。

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