降低病嬰接受靜脈注射過程重度疼痛率的專案成效

The Effectiveness of a Project to Reduce Infants’ Pain Responses during Intravenous Cannulation

靜脈注射會造成病嬰疼痛出現疼痛行為反應。本單位病嬰接受靜脈注射過程中常有大哭疼痛行為反應，調查發現其重度疼痛率達 87.5%，分析主要原因為缺乏兒科靜脈注射技術標準、缺乏止痛措施、缺乏固定和轉移注意力的輔具。本專案運用實證資料，進行改策略包含制定兒科靜脈注射技術標準並錄製教學光碟、推動使用表皮局部麻醉劑、使用固定肢體之輔具、運用多媒體電腦播放個別性之音樂或卡通、彩繪注射室環境及執行稽核機制。專案實施後，病嬰接受靜脈注射過程重度疼痛率由 87.5% 降到 32.0%，結果顯示提升護理人員注射技能、提供兒童友善環境，善用輔助工具，提供合適止痛藥，能改善病嬰接受靜脈注射過程之疼痛感。

 

Infants and young children present pain responses during intravenous cannulation procedures. In our unit, infants often cry and become alarmed during intravenous cannulation procedures. Our survey indicated that the severe pain rate of infants was 87.5%. and the influential factors were related to the lack of, first, technical standards for pediatric intravenous injections, second, use of analgesic, and third, assistive devices for fixation and distraction. This purpose of this project was to develop strategies to reduce the severe pain rate of infants in the unit. The proposed strategies include the development and promotion of pediatric intravenous technical standards and the recording of educational CDs, use of topical anesthetic agents for the epidermis, fixed limb assistive devices, use of multimedia to play music or cartoons, a painting room environment, and an audit mechanism. After the implementation of the project, the severe pain rate during intravenous injection was reduced from 87.5% to 32.0%. The results revealed that improving the injection skills of nurses, a child friendly environment, the use of assistive devices, and analgesics can reduce infant pain response during intravenous injection.