運用多元策略降低學齡前期住院病童靜脈注射疼痛之專案

Project of Applying Multiple Strategies to Relieve the Pain of Intravenous Injection in Hospitalized Preschool Children

10.29494/LN.202206_23(2).0010

郭稚榕(Chih-Jung Kuo)；謝宜芬(Yi-Fen Hsieh)；張玉婷(Yu-Ting Chang)

靜脈注射 ； 學齡前期兒童 ； 多元策略 ； 疼痛 ； intravenous injection ； preschool children ； multiple strategies ； pain

領導護理

23卷2期（2022 / 06 / 01）

136 - 151

繁體中文

靜脈注射是兒科住院病童最常見之醫療處置，而面對靜脈注射又以學齡前期病童的抗拒與疼痛反應最為激烈。本單位於2019年1－3月接獲5件靜脈注射相關客訴，引發專案成立動機。經調查發現病童不了解治療程序、先前有不好的注射經驗；家屬未適當安撫病童情緒、被迫在治療室外等候；護理人員未對病童進行衛教、靜脈注射照護行為完整率低；獎勵品過於單調、未提供減輕疼痛的藥物處置及靜脈注射標準流程不符合兒科特性等，導致病童靜脈注射疼痛反應得分高達7.65分。專案目的在降低學齡前期病童接受靜脈注射的疼痛行為反應，藉由治療性遊戲進行衛教、建置禮物牆與設置獎勵制度、提供局部麻醉止痛藥、修訂靜脈注射標準作業流程及進行稽核等，讓病童靜脈注射疼痛反應降至4.11分。本專案藉由多元策略降低病童對靜脈注射之疼痛行為反應，促進兒童正向治療經驗，提升臨床照護品質。

Intravenous injection is the most common medical treatment for hospitalized pediatric patients. Among these patients, preschool children demonstrate the strongest resistance and pain reactions when facing intravenous injection. The author's department received 5 intravenous injection-related complaints between January and March 2019, and consequently stimulated the establishment of this project. Investigations revealed that the intravenous injection pain response score of pediatric patients was as high as 7.65 due to the following reasons: the pediatric patient did not understand the treatment procedure or had bad injection experience previously; family members failed to calm the patient down, or were forced to wait outside the treatment room; the nursing staff did not provide health education to the patient, or the completion rate of intravenous injection care was low; the rewards were too monotonous, the nursing staff did not provide anesthetics, or the intravenous injection procedure was not tailored to meet pediatric patients' characteristics and so on. The purpose of this project is to soothe the intravenous injection pain response of preschool children. By introducing multiple strategies such as performing health education through therapeutic games, building a gift wall, and establishing a reward system, administering local anesthetics and analgesics, revising standard procedures for intravenous injection, conducting audits, and so on. This project reduced the intravenous injection pain response score of pediatric patients down to 4.11 points. By implementing multiple strategies to lessen the pain of intravenous injection in pediatric patients, this project provided children with positive treatment experience and improved the quality of clinical care.

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