主管:国家卫生健康委员会
主办:国家卫生健康委医院管理研究所
中国科技核心期刊(中国科技论文统计源期刊)
中国科学引文数据库(CSCD)核心库期刊
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中国护理管理 ›› 2022, Vol. 22 ›› Issue (1): 95-100.doi: 10.3969/j.issn.1672-1756.2022.01.020

• 循证护理 • 上一篇    下一篇

儿童外周静脉血标本采集的循证护理实践

李凤婷 杨芹 李佳丽 刘小玉 贾红艳 蒋萍萍 顾莺   

  1. 国家儿童医学中心 首都医科大学附属北京儿童医院风湿免疫科,100045 北京市(李凤婷,李佳丽,刘小玉,贾红艳,蒋萍萍);护理部(杨芹);国家儿童医学中心 复旦大学附属儿科医院护理部(顾莺)
  • 出版日期:2022-01-15 发布日期:2022-01-15
  • 通讯作者: 顾莺,博士,主任护师,护理部主任,E-mail:guying0128@aliyun.com
  • 作者简介:李凤婷,本科,主管护师,护士长
  • 基金资助:
    复旦大学循证护理中心证据转化与临床应用项目(Fudanebn202016);首都医科大学附属北京儿童医院护理专项项目(YHL201904)

Practice of evidence-based nursing in children's peripheral venous blood specimen collection

LI Fengting, YANG Qin, LI Jiali, LIU Xiaoyu, JIA Hongyan, JIANG Pingping, GU Ying   

  1. Department of Rheumatology and Immunology, National Children's Medical Center Capital Medical University Beijing Children's Hospital, Beijing, 100045, China
  • Online:2022-01-15 Published:2022-01-15
  • Contact: E-mail:guying0128@aliyun.com

摘要: 目的:将儿童外周静脉血标本采集的最佳证据应用于临床实践。方法:于2020年12月至2021年3月基于复旦大学循证护理中心证据的持续质量改进模式图的标准程序,将外周静脉血标本采集的最佳证据应用于临床。证据应用前、后分别以北京市某三级甲等儿童专科医院风湿免疫科的26名护士和208例次(证据应用前)、289例次(证据应用后)患儿为研究对象开展质量审查和效果评价,使用调查问卷调查护士对最佳证据的知晓情况,采用现场观察法评估护士对最佳证据实施的依从性,由检验中心反馈血标本合格率。结果:证据应用后护士对患儿握拳时机、双人固定及站位、压脉带的使用、血标本采集顺序这4个方面共计5个指标的知晓率提升,护士执行患儿身份确认、手卫生、压脉带使用、血标本采集顺序、佩戴一次性手套这5个方面共计7个指标的依从性提升,血标本合格率提高,差异均有统计学意义(P<0.01);证据应用前、后静脉采血穿刺成功率比较,差异无统计学意义(P>0.05)。结论:儿童外周静脉血标本采集最佳证据的应用可以提升护士对证据相关知识的知晓率和依从性,提高临床护理质量,提高血标本合格率,为患儿诊断治疗提供可靠依据,不影响穿刺成功率,不增加患儿痛苦。

关键词: 儿童;血标本;循证护理实践;质量改进

Abstract: Objective: To apply the best evidence of children's peripheral venous blood specimen collection to clinical practice. Methods: From December 2020 to March 2021, based on the standard procedure of the continuous quality improvement model of evidence from the Fudan University Evidence-Based Nursing Center, we applied the best evidence of peripheral venous blood specimen collection to the clinical practice. A total of 26 nurses, 208 and 289 children from the Department of Rheumatology and Immunology of a third-level children's hospital in Beijing were recruited. The quality was evaluated by the qualification rate blood samples. The effects were examined by investigating the knowledge of nurses about best evidence and their compliance with the best evidence before and after the application of the evidence. Results: After the evidence application, nurses' awareness of 5 indicators including the timing of children's fisting, fixation by two persons and positioning, usage of cuffs, and the order of blood specimen collection, was increased. The compliance with five aspects including identity confirmation, hand hygiene, usage of cuffs, order of blood specimen collection, and wearing the disposable gloves, was also improved. The qualification rate of blood samples was increased. All these differences were statistically significant (P<0.01). There were no significant differences regarding the success rate of blood sampling collection (P>0.05). Conclusion: The application of the best evidence for peripheral venous blood specimens collection in children can increase nurses' awareness and compliance with evidence-related knowledge, improve the quality of clinical care, and increase the qualification rate of blood specimens. The study provides a reliable basis for diagnosis and treatment of children. The evidence application does not affect the success rate of puncture and can decrease the suffering of patients.

Key words: children; blood samples; evidence-based nursing practice; quality improvement

中图分类号:  R47