Model essay on pediatric nursing 1: Application analysis of intravenous indwelling needle in pediatric nursing
Objective: To explore the application effect of intravenous indwelling needle in pediatric nursing. Methods: 50 pediatric patients in our hospital were randomly divided into control group and observation group, in which the observation group was given intravenous indwelling needle, while the control group was given routine nursing care by intravenous puncture. The nursing effects and nursing phenomena of the two groups were observed and compared. Results: There were obvious differences in surgical skills and complications between the observation group and the control group. The application effect of the observation group is obviously better than that of the control group, which has a strong nursing function, can better promote the treatment of pediatric children and has good clinical significance.
Pediatric nursing; Intravenous indwelling needle; Application effect
Intravenous indwelling needle is widely used in clinical nursing, especially in pediatric nursing. Intravenous indwelling needle has a good therapeutic effect. Intravenous indwelling needle is used for patients to realize intravenous infusion. Most patients who use intravenous indwelling needles need long-term treatment, and intravenous infusion and venipuncture are difficult, which can effectively improve the condition of such patients and promote their better rehabilitation. Compared with venipuncture, venous indwelling needle has the advantages of simple operation process, difficult puncture of blood vessels, flexible intubation and long venous indwelling time.
1 data and methods
1. 1 general data selection
50 pediatric patients in our hospital were divided into observation group and control group. There are 25 children in each group, including 26 boys and 24 girls, aged from 5 to 1 1 year. Children's hospitalization time is between 10 and 20 days. There was no significant difference in sex, hospitalization time and age between the two groups. Patients in both groups should be disinfected before puncture treatment to fully ensure the health of children.
1.2 method
Children in the observation group were treated with intravenous indwelling needle, while children in the control group were treated with traditional venipuncture. In routine venipuncture nursing, skin test and physical sign detection are carried out for patients first, and then the needle is pulled out after infusion. Patients in the observation group should fully observe the drug skin test, venipuncture and physical sign detection when intravenous indwelling needle is carried out. Both groups of patients need to be treated in a good environment to fully ensure that the children can achieve aseptic operation. Nursing staff should also strengthen patrol work. If children are found to have adverse reactions, they should be treated in time and do a good job of prevention. In the process of work, the staff should also make good shift changes and nursing records, implement the work according to the method of three checks and seven pairs, and do a good job in nursing children to the maximum extent. After the two groups of children completed the nursing work, they used the disease records to conduct a questionnaire survey on the patients, and analyzed the therapeutic effects of the two nursing methods, so as to evaluate the satisfaction of the families of the two groups of children with the nursing work.
2 The specific application of indwelling needle in pediatric nursing
In the process of indwelling needle, the skin should be disinfected through the puncture point, with the diameter of 6-8 cm as the center. Then perform puncture according to the standard, and hold the needle handle of the indwelling needle with the index finger and thumb, so that the included angle between the needle handle and the patient's vein is set at 15 to 30 degrees. Then the needle is inserted, and the needle core is retracted by 1-2mm under the condition of good blood return, and the sheath is sent into the blood vessel. Fix the indwelling needle cannula with the left hand, then pull out the needle core with the right hand, and finally specify the indwelling needle time with transparent application. Correct tube sealing operation can prevent complications. In the tube sealing work, first of all, we must pay attention to the positive pressure tube sealing, slowly inject 2-3-5ml of tube sealing liquid from the infusion needle in heparin cap, and then pull out the infusion needle while pushing the residual liquid, so as to ensure that the lumen is full to the maximum extent. Finally, the indwelling time of indwelling needle is about 4 days. After the indwelling needle is finished, the nursing work is also very important, which is related to whether the child will cause complications and infections. Therefore, aseptic operation should be adopted in nursing work, and the patient's condition should be observed at any time. If redness, dryness and exudation occur, corresponding measures should be taken immediately.
Three results
After comparison, it was found that the nursing effect of intravenous indwelling needle was better. Finally, the family members of the children scored the two nursing methods. The nursing score of venous indwelling needle was significantly higher than that of control group, and the incidence of complications in observation group was significantly lower than that in control group. The application of venous indwelling needle can effectively save the cost and relieve the pain of children, and the puncture success rate is high, and the nursing effect of venous indwelling needle is ideal.
4 discussion
The nursing effect of venous indwelling needle in pediatric nursing is obviously better than that of routine puncture, but prevention and disinfection should be strengthened in the nursing of venous indwelling needle to reduce the probability of complications and prevent infection and tube blockage. The phenomenon of blocking the tube is mostly due to the blood blocking the indwelling needle, and finally the drug can not enter the body, and phlebitis is very tolerant, which leads to the fragility of the patient's blood vessels. Therefore, close observation and nursing are very important for children's health. In the nursing work of venous indwelling needle, we should choose the puncture site and model consistent with the children, and the staff should be as skilled as possible to fully alleviate the pain of the children. In the process of puncture, it is necessary to ensure the sterility of the needle and the disinfection of the skin to the maximum extent, and observe the patient's condition after the needle is left in place to fully prevent complications. Only by doing a good job of intravenous indwelling needle can we maximize it. With the rapid development of economy and the gradual improvement of people's living standards, parents have higher requirements for hospitals, and most of them require successful puncture treatment at one time. Therefore, the nursing method of venous indwelling needle can achieve a higher success rate of puncture, and it is easier to fix, which reduces the pain of children to the greatest extent and improves the work efficiency and quality to the greatest extent. In addition to doing patrol work, staff should also increase communication with children to relieve their psychological pressure.
5 abstract
In a word, the application effect of intravenous indwelling needle is very ideal, which can effectively alleviate the pain of patients and reduce the cost. However, disinfection should be done well in the nursing work of intravenous indwelling needle, and aseptic operation process should be adopted to minimize the occurrence of complications. The effect of intravenous indwelling needle in pediatric nursing is very ideal and has good clinical significance.
refer to
[1] Sheng Jingyi, Shi Yujing, Sudan. Application and experience of intravenous indwelling needle in pediatric nursing [J]. Application of modern drugs in China, 2013,7 (22)
[2] Ye Tangqiu. Application and experience of intravenous indwelling needle in pediatric nursing [J]. Medical Information, 20 14, (24)
[3] Zhang Aiping. Application of intravenous indwelling needle in pediatric nursing [J]. Medical Information, 20 14, (24)
[4] Zhou Lingyun. Observation on the effect of two fixation methods of intravenous indwelling needle in children [A].20 12 Proceedings of the National Symposium on Pediatric Nursing [C].20 12
[5] Huang Changgui. Observation on the application of indwelling needle in great saphenous vein in pediatric nursing [J]. Everyone's health (later edition), 20 14, (1)
Moire. Effect analysis of intravenous indwelling needle in pediatric nursing [J]. Chinese and foreign medicine, 20 14, (33)
The influence of PDCA circulation management on the quality of pediatric nursing
Objective: To observe and discuss the role of PDCA circulation management in improving the quality of pediatric nursing. Methods: 300 children who came to our hospital from April 38, 1965 to March, 1965 were selected as the experimental group, and PDCA circular nursing management method was used for nursing. 300 children with routine nursing methods from April 20 12 to March 20 13 were set as control group. The satisfaction of patients with nursing quality, the results of nursing quality score and the incidence of complications or hospital infection in the nursing process were compared between the two groups. Results: The satisfaction of children in the control group was lower than that in the experimental group. Compared with the nursing quality score of the two groups, the score of the experimental group was higher than that of the control group; The number of patients with complications or hospital infection in the control group was higher than that in the experimental group. Conclusion: PDCA circulation management can obviously improve the quality of pediatric nursing, help children recover as soon as possible and improve the quality of life, which is worth popularizing in pediatric nursing.
Keywords PDCA pediatrics; Nursing quality
PDCA cycle management was first put forward by Dr. Deming, an American quality management expert, as a scientific procedure of total quality management [1]. The whole process of total quality management activities includes the formulation and organization of quality plans, which is a PDCA cycle that runs endlessly. PDCA is the acronym of English words "plan", "do", "check" and "act", and the quality management is carried out in this order in cycles [2-3]. In recent years, PDCA has introduced nursing from enterprise management and implemented it as a strategy to improve nursing quality [4]. The application of PDCA circulation management in pediatrics of our hospital has obviously improved the quality of pediatric nursing. The report is as follows.
1 data and methods
1. 1 general information
300 children who came to our hospital from April 20 13 to March 20 14 were selected as the experimental group, including male 139 and female 16 1. The age ranged from 0.5 to 4 years, with an average of (1. 1? 0.4 years old. 300 children who did not implement PDCA management from April 20 12 to March 20 13 were set as the control group, including male 166 and female 134. The age ranged from 0.6 to 4 years, with an average of (1.3? 0.5 years old. There is no significant difference in age and sex between the two groups (P & gt0.05), which is comparable. Because the child is young and has no judgment ability, his informed consent form is signed by the legal guardian.
1.2 nursing methods
The control group was given routine nursing methods, while the experimental group was given PD-CA circulation management methods. The whole management process includes four stages, namely, planning stage, execution stage, inspection stage and treatment stage, as follows:
1.2. 1P (planning stage) Divide the nursing staff into several quality monitoring groups and check different items. When allocating resources, we should pay attention to the prediction of the peak period of pediatric diseases and arrange manpower and material resources reasonably in order to deal with the epidemic situation in time and effectively; Pay attention to the rational distribution of senior nurses and junior nurses, realize mutual supervision and bring the old with the new. Set work objectives, including improving the basic professional knowledge of pediatric nursing; Senior nurses lead junior nurses, strengthen nursing skills training, strictly abide by the principle of sterility, and improve the success rate of scalp venipuncture in children; Improve employees' legal awareness and concept, and strengthen legal study; Do a good job in newborn care, keep the environment warm and comfortable, meet the requirements of supporting facilities, lighting, temperature and humidity, and increase the training of nursing staff on baby touching skills; Improve the communication skills between nurses and children. According to the goal, formulate detailed implementation plan, effect prediction, process arrangement, responsible person, performer and gymnastics method.
1.2.2D (implementation phase) The work plan shall be made in the implementation planning phase. Everyone participates in the management activities of quality monitoring, and cultivates the sense of responsibility and teamwork spirit that nurses should have in their work. Pediatric children are young. Nurses should actively, completely and enthusiastically provide nursing services for children and their families, eliminate the discomfort and tension of children in the new environment, and establish confidence and trust in treating diseases. In the implementation stage, we should conscientiously implement our respective work according to the requirements of plan, time, quantity and quality. Pay attention to cultivating nurses' working ability and accomplishment, and supervise nurses to carry out nursing work according to standard operating methods. So as not to affect the implementation results.
1.2.3C (inspection stage) The work in this stage is mainly to check the implementation of the formulated work plan, check the quality of the work completed every day, and compare it with the expected effect, so as to ensure that the members of the quality monitoring team can reach the specified goals every day, find out the problems existing in the implementation and correct them in time to ensure the smooth progress of the work. Attention should be paid to some details in nursing, such as the eye-catching and timely pasting of bedside cards, and the clean nursing of scalp vein catheterization for hospitalized children. The head nurse checks the overall work every month and gives guidance and correction to avoid mistakes caused by negligence.
1.2.4A (processing stage) held a forum, and the quality control team summarized the work of each month, reflected on the completion of the work, summarized the inappropriateness or mistakes in the work, and made improvement plans so as to make improvements in the work of next month. The communication between members and the promotion of personal accumulated experience and lessons are of warning or guiding significance to each other's work. For the problems that individuals can't solve, the group should discuss with each other, help to make improvement plans and work objectives for the next month according to the work situation this month, and promote the continuous improvement of nursing quality. The above four stages do not exist separately, but are closely related. In practical work, these four stages run in a continuous cycle.
1.3 evaluation criteria
1.3. 1 When considering the satisfaction of nursing quality, the following evaluation factors should be included, namely, nurses' skill operation ability, nurses' service attitude and health education. Make a questionnaire and ask the child's guardian to fill it out before the child leaves the hospital. Satisfaction is divided into three grades, namely, satisfaction, relative satisfaction and dissatisfaction. The overall satisfaction of nursing quality is the sum of satisfaction and relative satisfaction.
1.3.2 nursing quality
(1) nursing quality score. The quality monitoring group established the nursing quality control standards for the basic nursing management, super nursing management, first-aid articles management, disinfection and isolation management, nursing document management, health education management and hospital infection management of the two groups of children. The quality monitoring group scores all the indexes according to the nursing quality control standards.
(2) The incidence of complications or infections in nursing. During the nursing process, the number of complications in the two groups was recorded.
1.4 statistical processing
Use SPSS 17.0 software to analyze the data, use t-test to compare the measurement data, and use the counting data. 2 check, Wilcoxon rank sum test is used to compare rank data. Test level? =0.05。
2 discussion
In traditional nursing methods, nurses simply introduce the hospitalization environment and rules, monitor vital signs, and give health education to patients before discharge [5]. The defects of nurses' consciousness, professionalism and environment in the process of work often reduce the quality of nursing and are not conducive to the treatment of children. In PDCA circulation management, the monitoring of nursing quality has been strengthened, the work of each nursing staff has been urged, the link of finding and solving problems has been strengthened, and the awareness, professional skills and hospitalization environment of nursing staff have been improved, achieving the following points:
(1) urge nursing staff to have a correct attitude and work actively.
(2) Through assessment, strengthen the basic operation skills of nursing staff, accumulate experience and cultivate the ability to deal with more complicated situations.
(3) Improve the nursing staff's attention to nursing work and help them correct their working attitude [7-8].
(4) Improve nurses' awareness of various problems and epidemic peaks.
(5) Cultivate nurses' awareness of legal protection.
(6) Improve the overall ability of the hospital to control and prevent diseases [9- 1 1]. The results show that the satisfaction of nursing quality in the experimental group is higher than that in the control group, and the nursing quality score is also higher than that in the control group, and the incidence of complications is lower than that in the control group. To sum up, PDCA cycle can significantly improve the quality of pediatric nursing, and it is worth popularizing in pediatric nursing, which can better help children recover their health and improve their quality of life.
refer to
[1] Wang Li,. Application of PDCA circulation management in sputum culture specimens [J]. China General Medicine, 20 13,11(10):1627-1628.
[2] Zhang Yanjun. The application of PDCA cycle in hospital science and technology archives management [J]. Hebei Medical College, 20 12, 18 (4): 564-565.
[3] Shen Huili. Application of PDCA circulation management in pediatric nursing shift [J]. chinese medicine guides, 20 13, 1 1(28):542-543.
Zhu Junyi, Zhang Chunqiong, Chen Liming, et al. Effect of PDCA circulation management on renal fistula after percutaneous nephrolithotomy for multiple kidney calculi [J]. China Disability Medicine, 2014,22 (6): 828-829.
[5] Li Xinxin. Role of PDCA circulation in improving limb function after breast cancer surgery [J]. China's rehabilitation theory and practice, 20 12,18 (2):178-180.
Wang Lihua, Miao Tao, Zhu Lingfeng, et al. Managing ward environment with PDCA model [J]. Chinese Journal of Nursing, 20 1 1, 46 (9): 893-895.
[7] Xiao Xiuli. Application of PDCA circulation in hospital infection management [J]. China Journal of Hospital Infectious Diseases, 20 10/0,20 (11):161.
Li Qingan Li Aimin Gaizhi. Application of PDCA cycle in the management of nosocomial infection in neonatal intensive care unit [J]. China Journal of Newborns, 20 1 1, 26 (4): 262-263.
[9] Wang Sujuan, Zhang,. PDCA cycle in the establishment and practice of management assessment system in our hospital [J]. China Journal of Hospital Management, 2013,29 (2):156-158.
[10] Song Dan, Sun Qiuhua. Application progress of PDCA in nursing management [J]. Journal of Baotou Medical College, 2013,29 (6):147-149.
[1 1] Zhuang sufang, huo dianqin. Application of hidden danger discovery system and PDCA management method in nursing risk management [J]. Journal of Zhejiang University of Traditional Chinese Medicine, 2012,36 (1): 98-100.
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