運用兒童友善醫療降低學齡前期病童靜脈注射之抗拒行為

Apply Child-Friendly Healthcare Concept to Reduce Resistance Behavior of Preschool Children Receiving Intravenous Injection

本院兒童病房學齡前期(3-6歲)病童約佔65%，有高達84%的病童在靜脈注射時出現抗拒行為，抗拒行為平均分數為5.4分。故本專案旨在運用兒童友善醫療降低學齡前期病童靜脈注射之抗拒行為。經調查原因為學齡前期病童靜脈注射流程不完善、病童注射前心理準備不足、注射過程缺乏控制感、過去不良經驗、缺乏兒童友善醫療環境。藉由人員教育訓練、修訂學齡前期病童靜脈注射流程、製作靜脈注射衛教流程示範帶及兒童版靜脈注射衛教、提供注射方式的選擇、美化環境、給予實質鼓勵後，學齡前兒童抗拒行為比率降為40%，抗拒分數降為2.5分。專案實施後病童注射時的抗拒行為減少，增加家屬滿意度，減輕護理人員壓力，營造良好護病關係，提升兒科照護成效與品質。

On average, about 65% of the patients in our pediatric general ward are preschoolers (age 3-6). As high as 84% of these exhibit resistance behaviors during intravenous injection, with an average score of 5.4 in resistance. The purpose of this project was to apply the child-friendly healthcare to reduce the resistance behavior during intravenous injection in preschoolers. We identified through investigation the reasons behind the behaviors: lack of standardized procedure, lack of psychological readiness before injection, helplessness during injection, unpleasant experience of injection in the past, unfriendly environment, and lack of child-friendly healthcare concept. We implemented the following nursing measures: staff training, modified intravenous injection procedure, produced video and brochure to demonstrate injection procedure, provided alternative injection choices, decorated injection environment, and offered small gifts to children. After implementing the above mentioned interventions, the percentage of resistance behavior against intravenous injection in preschool children decreased from 84% to 40%, and the scores of resistance decreased from 5.4 to 2.5. The decrease in behavior also came with an increase in the parents’ satisfaction, a decrease in the nurses’ stress, an improvement in the nurse-patient relationship, and a upgrade in the efficacy and quality of our pediatric healthcare.