提昇急診兒科病患靜脈注射安全及照護完整性

Modalities to Improve the Safety and Nursing Care of Emergency Room Pediatric Patients Being Given Intravenous Injections

本專案目的在提升急診護理人員靜脈注射技術技能、靜脈用藥認知及正確護理指導，以提升急診兒科病患靜脈注射安全。由現況發現兒科靜脈注射異常件數高，經自擬之問卷及觀察表得知，護理人員在靜脈注射及用藥安全認知正確率低、執行靜脈注射完整性低，導致急診兒科病患靜脈注射不安全。藉由舉辦在職教育、增加輔助設備“靜脈注射燈”、製作衛教輔助工具、建立電腦藥囑連結查詢等改善措施，改善後護理人員對於兒科靜脈注射照護及用藥安全認知由88.6%提升至97.5%；靜脈注射完整性由70.9%提升至97.5%；靜脈注射部位異常件數由13件降為2件。

This project was designed to improve the safety of intravenous injections on emergency room pediatric patients by improving nursing staffs' intravenous injection technique, encouraging them to know more about intravenous injection medication, and providing accurate nursing information to the parents. It has been found that there were higher-than-expected adverse events while performing intravenous injections for emergency room pediatric patients. In this regard, a questionnaire showed that intravenous injections for emergency room pediatric patients was unsafe because nursing staff did not have sufficient knowledge to provide medication injection and did not perform the injection properly. This was improved by providing continuous education for the nursing staff and adding auxiliary equipment such as additional illumination, designing teaching tools to assist patient education and by establishing an on-line databank for drug inquiries. Following these management changes, the accuracy rate for the nursing staff to answer questions correctly regarding intravenous injection improved from 88.6% to 97.5%. The rate of performing proper intravenous injection improved from 70.9% to 97.5%, moreover, reports of adverse events of intravenous injection decreased from 13 to 2 during the same length of time.