降低接受預防接種及餵食輪狀疫苗嬰兒疼痛反應改善專案

A Project to Reduce Pain of Infant from Vaccine Injection by Administration of Rotavirus Vaccine Prior to Vaccine Injection

背景：預防接種是健兒門診每日重要業務，本院約有71.5% 家長選擇自費口服輪狀病毒疫苗暨預防接種注射。其中80.1% 的嬰兒在預防接種後，出現中、重度疼痛反應，分析原因為護理人員執行注射與餵食疫苗流程不一、父母專注嬰兒吞嚥疫苗情形，忽略預防接種後嬰兒疼痛情緒安撫。目的：專案旨在餵食輪狀病毒疫苗暨降低嬰兒預防接種中、重度疼痛反應。解決方案：自2015 年5 月1 日至2016 年2 月28 日，經舉辦在職教育、制訂輪狀病毒疫苗衛教單及疫苗預防接種流程。本專案護理人員先餵食輪狀病毒疫苗再執行預防接種注射，並即時協助家長安撫嬰兒。結果：嬰兒中、重度疼痛反應發生率80.1% 下降至55.1%。結論／ 實務應用：建議臨床除了優先餵食嬰兒輪狀病毒疫苗再執行預防接種注射，應增加標準化預防接種注射流程，包含給予疫苗順序、嬰兒口服疫苗姿勢、護理人員協助嬰兒預防接種注射後抱予父母姿勢、護理人員的安撫技巧及教導父母安撫技巧等，有效降低嬰兒疼痛反應。做為執行預防接種及餵食輪狀病毒疫苗護理人員之照護參考。

Background: Immunization is an important daily practice in well-baby clinics. Approximately 71.5% ofinfants received rotavirus vaccine in combination with vaccine injection in our well-baby clinics. About80.1% of infants experienced moderate or severe pain from vaccine injection. The possible reasons are(1) inconsistent procedure of immunization for feeding rotavirus vaccine and injection vaccines (2)insufficient pacified behavior of parents after infant injection vaccines (3) lack of comfort from parentsafter immunization due to parents focusing on infants swallowing the rotavirus vaccine.Purpose: The purpose of this project was to reduce moderate to serve pain induced by vaccine injection.Methods: The intervention were applied from May 1, 2015 to Feb 28, 2016, including continuingeducation for nurses, standardization of immunization protocol, and establishment of vaccinationguidelines.Results: Incidence race of moderate or severe pain of infant induced by vaccine injection reduced from80.1% to 55.1%.Conclusions: This evidenced-based project demonstrates that feeding rotavirus vaccine prior to vaccineinjection can decrease infant’s pain. In addition, standardized injection procedure including ordersof giving vaccines, positioning infant for feeding vaccines, parent’s holding position of infant afterinjection, and health education of nurses teaching parents pacified behavior also helps reduce infant’s painreaction. Our project provides a useful reference for nurses in the administration of rotavirus vaccine incombination with vaccine injection.