郑贵清

[摘要] 目的 探讨持续质量改进在小儿静脉留置针穿刺护理管理中的应用效果。 方法 选择2017年6～11月期间我院小儿科收录的104例静脉留置针患儿为例，根据护理方法不同，随机分为对照组与观察组，各52例。其中，对照组采用常规护理，而观察组采用持续质量改进护理进行干预，比较两组患儿护理情况。 结果 研究分析发现：①观察组患儿家属对护理满意度比对照组高，且差异有统计学意义（P<0.05）；②观察组患儿一次穿刺成功率、留置3～4 d比例均高于对照组，且差异具有统计学意义（P<0.05）；③观察组患儿静脉炎、堵管、针眼感染及针体滑出等不良反应发生率均低于对照组，且差异具有统计学意义（P<0.05）。 结论 对于小儿静脉留置针情况，采用持续质量改进护理干预，避免患儿身体不适，降低不良反应发生率，提高一次性穿刺成功率及护理质量，在临床上可值得推广与应用。

[关键词] 持续质量改进；静脉留置针；穿刺护理管理；应用效果

[中图分类号] R473.72 [文献标识码] B [文章编号] 1673-9701（2018）25-0155-03

[Abstract] Objective To explore the application effect of continuous quality improvement in the management of pediatric venous indwelling needle puncture care. Methods A total of 104 children with venous indwelling needles were collected from our department of pediatrics from June to November 2017 as an example. According to different nursing methods， they were randomly divided into control group and observation group， with 52 patients in each group. Among them， the control group received routine care， while the observation group was intervened with continuous quality improvement care. The nursing of the two groups was observed and compared. Results The study found that the nursing satisfaction of the family members of the observation group was higher than that of the control group， and the difference was statistically significant（P<0.05）. The one-time venepuncture success rate and the rate of indwelling 3-4 d in the observation group were higher than those of the control group， and the difference was statistically significant（P<0.05）. The incidence of adverse reactions such as phlebitis， blocked tube， needle infection， and needle slip was lower in the observation group than that in the control group. And the difference was statistically significant（P<0.05）. Conclusion For pediatric venous indwelling needles， continuous quality improvement nursing interventions are used to avoid physical discomfort， reduce the incidence of adverse reactions， improve the success rate of one-time puncture and the quality of care， which may be worthy of clinical application.

[Key words] Continuous quality improvement； Venouindwelling needle； Puncture care management； Application effect

目前，在臨床上，对小儿疾病的治疗多以静脉输液为主[1]。由于小儿自身因素的限制，反复穿刺会造成患儿恐惧心理。而静脉留置针的应用，虽然减少了患儿多次穿刺的痛苦，但是小儿在临床上是特殊的群体，身体发育尚不完善，对各方面的承受能力有限[2]。持续质量改进基于全面质量管理上，根据医院护理与其他方面的管理，从而在小儿静脉留置针穿刺护理管理中取得不错的效果。有研究明确指出[3]，持续质量改进（CQI）在小儿静脉留置针穿刺护理管理中的应用效果明显。本次研究以我院小儿科收录的104例静脉留置针患儿为对象，进一步观察与分析持续质量改进在小儿静脉留置针穿刺护理管理中实际应用效果，现报道如下。

1资料与方法

1.1一般资料

本次以2017年6～11月期间我院小儿科收录的104例静脉留置针患儿为研究对象，所有患儿均符合静脉留置针穿刺相关的诊断标准，患儿家属签订知情同意书，并且该研究经伦理学委员会批准。……