周邊靜脈留置護理改善專案

Improving the nursing care of intravenous catheterization

本專案旨在改善周邊靜脈留置照護之護理品質，期望經由提昇靜脈留置照護品質降低住院病人非計劃靜脈注射率，實施病房爲中部某區域醫院二樓病房，改善前病人靜脈留置非計劃注射率爲34％，耗費護理工時成本、衛材成本之總金額爲54500元，探究其原因爲：1.護士靜脈注射技術不佳、2.經驗不足沒有信心、3.未按標準技術操作、4.衛教不完整、5.病人不配合或自拔。專案實施時間爲91年7月至91年12月，實施期間以：1.在職教育、2.技術回覆示教、3.修定注射及照護標準流程、4.定期評核注射技術、5.制定病人標準衛教單張及掛圖。實施後住院病人靜脈非計劃重注射率降爲8.2％，專案實施後可節省之護理工時成本、衛材成本，每月粗估約44340元，經此專案後，護理人員靜脈留置注射品質有顯著之提昇，更經由此專案提昇本單位之護理服務照顧。

The object of this study is to improve the quality of nursing care in peripheral intravenous catheterization. The anticipation is to lower inpatient's non-planned intraveneous injection by improving the guality of nursing care. The target ward of this study is located at a local hospital second floor in central Taiwan. The rate of 'nonplanned intravenous injection' before the improvements was 34%. The cost involved in nursing hours and materials was NT54,500. The reasons found were: 1) Lack of technical expertise in intravenous injection. 2) Lack of experience and confidence. 3) The standard procedure was not followed correctly. 4) Technical health education was inadequate. 5) Patient incompliance or self-removal of catheter. The period of this study was between July 2002 and December 2002. The improvements completed in the care of intravenous catheterization in this study include: 1) On-site technical health education. 2) Reverse education in technical procedures. 3) Revise the injection and nursing care standard protocol. 4) Periodic evaluation of injection techniques. 5) Create standard patient health education handouts and posters. After the improvements were completed, the 'non-planned intravenous injection rate' was lowered to 8.2%. The savings involved in nursing hours and materials was roughly estimated to be NT44,340 per month. After this study was completed, it is observed that there is a significant improvement in the technique of intravenous catheterization installation by the nursing staff. Subsequently, the quality of nursing care in this department was also improved.