降低學齡前期病童靜脈注射過程行為反應之專案

Reducing Behaviors Responses to Receive Intravenous Injection for Preschool Children

10.6299/JHA.2016.3.3.R7.68

李佳玲(Chia-Ling Li)；何岱爭(Tai-Cheng Ho)；張志明(Chih-Ming Chang)

學齡前期 ； 靜脈注射 ； 行為反應 ； preschool ； Intravenous Injection ； behavioral response

健康與建築雜誌

3卷3期（2016 / 10 / 01）

68 - 77

繁體中文

背景：學齡前期兒童於住院期間面對不熟悉的人與環境易產生分離焦慮等護理問題。執行侵入性治療，如靜脈注射的痛苦將被放大。護理人員於靜脈注射過程中，往往將家屬隔離在治療室外，並使用更多的人力將病童固定於治療床上。目的：本專案旨在降低學齡前期病童靜脈注射過程行為反應。方法：利用結構式問卷及訪談收集73名病童於靜脈注射過程行為反應：有不好的注射經驗；缺乏注射技術訓練；單調的天花板及牆壁等。擬定解決方案: 可選擇注射姿勢、重新制訂兒科靜脈注射流程、製作適當的輔具、於天花板架設電視及牆面重新佈置。結果：方案實施後，重度行為反應下降至33.9%，達目標值，期此專案能提供醫護單位病童執行靜脈注射之參考。結論與應用：許多病童住院接受靜脈注射時常有反抗等行為出現。當護理人員發現病童無法配合時，家屬常有許多干預醫療行為出現，專案實施後，使用輔助固定裝置及轉移注意力可有效降低病童行為反應。

Background: When faced with unfamiliar people and environment during hospitalization, preschool children tend to experience nursing issue, such as separation anxiety. As a result, the pain caused by invasive treatments, such as intravenous injection, will be enlarged. During intravenous injection, nursing personnel usually have to isolate family members from treatment room and use more manpower to fix sick children on treatment beds. Purposes: The main purpose of this project is to reduce preschool children's behavioral responses to intravenous injection process. Methods: This study used structured questionnaire and interview to collect the behavioral responses to intravenous injection process of 73 sick children: a prior bad experience about injection; lack of injection skill training; dull ceiling and walls. Proposed solutions: alternative injection position, re-development of pediatric intravenous injection procedures, development of adequate aids, installation of TV on ceiling, and renovation of walls. Results: After the implementation of this project, severe behavioral responses were reduced by 33.9%, reaching the target value. It is hoped that this project can be provided as reference for medical and nursing units to administer intravenous injection to sick children. Conclusions and Application: Many children tend to display behaviors of resistance when receiving intravenous injection during hospitalization. Nursing personnel found that children were unable to cooperate with them and family members usually displayed many behaviors of medical interventions. After the implementation of the project, the use of aids fixtures and distraction could effective reduce children's behavioral responses.