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    護理干預對預防新生兒皮膚抓傷和管道脫落的效果觀察

    時間:2019年07月03日 所屬分類:醫學論文 點擊次數:

    摘要:目的:在臨床上,研究對新生兒采取護理干預的方案進行護理后的價值。方法:選取某院新生兒,例數合計為200例,選取時間范圍是2017年5月5日~2018年3月5日,將其依據隨機數字表法原則分兩組,100例為一組。一組給予基礎臨床方案為主護理(對照組),另一

      摘要:目的:在臨床上,研究對新生兒采取護理干預的方案進行護理后的價值。方法:選取某院新生兒,例數合計為200例,選取時間范圍是2017年5月5日~2018年3月5日,將其依據隨機數字表法原則分兩組,100例為一組。一組給予基礎臨床方案為主護理(對照組),另一組再聯合使用護理干預(觀察組),對比兩組的皮膚抓傷、胃管脫落、留置針管脫落、鼻導管脫落指標。結果:觀察組新生兒在護理后,其發生皮膚抓傷數據0.00%、發生胃管脫落數據0.00%、留置針管脫落1.00%、鼻導管脫落1.00%,各指標綜合評價和對照組相比,均有統計學意義,P<0.05。結論:實施護理干預方案于新生兒當中,新生兒的皮膚抓傷、管道脫落等狀況發生概率較低。

      關鍵詞:護理干預,新生兒,皮膚抓傷,胃管脫落

    護理實踐與研究

      在臨床新生兒住院期間,部分新生兒需要采取吸氧、輸液等方式的治療[1],其中前者主要使用導管吸氧、后者則為靜脈留置針輸液方式。但是,由于新生兒年幼,沒有自主意識和自我控制的能力,經常在治療期間會表現出哭鬧、躁動、無法完成護理依從等情況發生,從而會導致在治療期間,會出現皮膚抓傷、管道脫落等不良事件[2]。本文當中,對本院2017年~2018年這段時間收治的新生兒實施護理方面的分析和總結。

      1資料與方法

      1.1資料

      選取本院的新生兒200例,所選時間區間是2017年5月5日~2018年3月5日,將其隨機數字表法分組,分為觀察組100例、對照組100例。觀察組中男50例,女50例,平均胎齡(38.72±1.57)周;對照組中男51例,女49例,平均胎齡(38.48±1.86)周。對比兩組新生兒資料,P>0.05。

      1.2方法

      對照組采用基礎臨床方案。本組新生兒以基礎的新生兒護理為主,主要包括[3]:(1)按照“三查八對”制度和無菌操作方式對患兒進行置管護理;(2)對于新生兒進行的經口留置胃管、鼻導管、留置針輸液管等實施常規方式固定和護理。觀察組采用基礎臨床方案+護理干預方案。本組新生兒在基礎方案實施同時,再進行護理干預:(1)針對新生兒的靜脈留置針輸液護理,首先使用固定束縛帶固定好導管,并盡量做好新生兒的體位護理,保持其舒適狀態,以防止新生兒發生哭鬧、躁動導致導管脫落[4]。

      (2)針對新生兒的鼻導管吸氧護理,使用3L防過敏膠帶剪成蝶翼圖形,固定在新生兒的鼻子和導管前部,防止導管移動和新生兒觸碰[5];(3)針對新生兒的經口留置胃管護理,使用3M敷貼固定好新生兒的胃管,根據新生兒的面部尺寸、好動情況等,將敷貼固定在其下頜處,以做好最佳的固定方式[6];(4)輸注藥物護理,在輸注之前,需要衡量和定奪新生兒能夠承受的刺激范圍,若藥物屬于刺激性藥物,則在輸注過程中,需要控制好緩慢的速度,并維持新生兒固定的體位,以防止新生兒亂動后導致輸注失敗;同時在輸注期間,需要做好新生兒的腹瀉、感冒等預防和保暖工作;(5)舒適固定護理,可使用無菌紗布、棉布等制作成小手套,將新生兒的手部包裹好,從而能夠在保護新生兒手部同時,防止其抓傷自己皮膚,但是包裹時需要注意力度,防止發生新生兒手部循環障礙。

      1.3觀察指標

      測評兩組新生兒的狀況發生情況,包括皮膚抓傷情況、胃管脫落情況、留置針管脫落情況、鼻導管脫落情況等。

      1.4統計學處理

      核算軟件為SPSS22.0版本,其中兩組新生兒的皮膚抓傷、胃管脫落、留置針管脫落、鼻導管脫落概率實施“%”形式反映,并采取χ2值檢驗,結果顯示為P<0.05時,說明兩組新生兒的上述指標對比有統計學意義。

      2結果

      觀察組新生兒的皮膚抓傷、管道脫落各項狀況的概率,顯著低于對照組,P<0.05。

      3討論

      在對新生兒進行護理的過程中,需要重點進行保障的是防止其發生皮膚抓傷和妥善固定好導管等,以防止因為新生兒的無意識、無自主能力導致其發生胃管脫落、氧氣管脫落、輸液針掉落、皮膚抓傷等風險事件。臨床目前而言,主要針對新生兒的上述風險,采取的傳統方式為手部固定約束,但該方式會導致新生兒嬌嫩的肌膚不適,并影響其活動,故而其弊端較大,需要采取一定的護理干預在保證風險事件降低同時,保護好新生兒的肌膚。

      本文當中,為了有效的降低新生兒的風險發生情況,采取分組對照的方式,對兩組新生兒實施不同的方案護理,其中一組使用基礎臨床方案,另外一組再聯合使用護理干預,得出后者的效果更加理想。本研究結果顯示,觀察組新生兒在采取護理干預的方案進行護理后,其皮膚抓傷概率0.00%、胃管脫落概率0.00%、留置針管脫落概率1.00%、鼻導管脫落概率1.00%,總體發生情況少于僅使用基礎臨床方案的對照組新生兒發生概率,P<0.05。此現象表示為兩組在對比各項發生狀況的指標方面,觀察組新生兒的情況較對照組有明顯的優勢。總而言之,在臨床上給予新生兒使用護理干預的方案,其在控制新生兒發生皮膚抓傷、管道脫落等方面的效果理想。

      參考文獻

      1黃妙霞,黃妙然,李小鳳,等.護理干預對預防新生兒管道脫落與皮膚抓傷的效果分析.黑龍江醫學,2015,39(8):967~968.

      2宋麗莉,劉楊.精細化管理在新生兒床旁護理同質化服務中的應用效果.中華現代護理雜志,2016,22(15):2170~2172;2173.

      3廖秀春,廖艷嬌.新生兒胎糞吸入綜合征應用臨床路徑護理對患兒生活質量的影響效果.護理實踐與研究,2017,14(16):76~77.

      4宗小敏,王模奎.集束化護理干預措施預防新生兒呼吸機相關肺炎的效果.中國感染控制雜志,2016,15(4):266~268.

      相關刊物推薦:《護理實踐與研究》雜志是新聞出版署批準的護理學術綜合性期刊。國際刊號ISSN:1672-9676,國內刊號CN:13-1352/R,國內外公開發行。及時傳遞護理學科發展的新動向及新信息,交流護理經驗;突出護理學科的科學性、理論性及實用性;注重理論與實踐相結合,普及與提高相結合。

      

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