First, change the nursing concept and put the "people-oriented" nursing concept into practice.
In the traditional intravenous infusion therapy, nurses seldom treat patients as a whole, only carry out medical orders mechanically, and there is a lack of effective communication between nurses and patients. With the development of modern nursing, the nursing mode of infusion has changed from simple technical nursing mode to people-oriented nursing mode. Through the development of "people-oriented" humanized nursing service, the nursing concept has been changed, the nurses' awareness of actively serving patients has been enhanced, and the service quality has been improved.
1. Create a warm infusion environment. Posters and various warm reminder boards are posted on the walls around the lobby and infusion room, and hot water, disposable cups, paper and pens, hot water bottles, plastic bags and toilet paper are provided for patients to take. The infusion room should be kept clean and disinfected regularly every day, and the cleaning staff should take the initiative to patrol, clean up the scraps of paper and articles on the ground at any time, and keep it clean to prevent cross infection. Let the children have a relaxed and happy infusion in a clean, elegant and comfortable environment.
2. Love and respect the communication with children before blood transfusion operation, and adopt various support methods such as encouragement, praise, praise, listening and touching to gain the trust of children and establish an equal and friendly nurse-patient relationship. For example, children aged 0 ~ 18 months generally use scalp intravenous infusion. When everything is ready, let the child lie down for puncture to reduce the time of fear and crying. For children aged > 18 months, hand and foot puncture should be selected according to the situation. If conditions permit, let the child choose the injection site by himself, and then say some encouraging words: "I know you are the bravest, and you will definitely not cry", "Little man, you are the strongest, and you are not afraid of pain", "Come on, you are the best. Give your hand to your aunt and give it to her. For some children who can cooperate with puncture, let them play the role of role models, and at the same time hint and encourage the children: "You are the big brother (big sister), and your little brother (little sister) is watching you. You should lead by example, like your big brother (big sister), your aunt likes you best. I'll gently give you the smallest needle, okay? ".At the same time, kindly ask her age, which kindergarten she went to, how many five-pointed stars she has, and so on. When her attention is distracted, she can complete the puncture quickly and gently. When the child cooperates to complete the puncture, say some compliments such as "You are great", "You are brave" and "You are like a big brother (big sister)", and give some small stickers and candy rewards in time to make the child feel respected and satisfied, and at the same time minimize the actual pain.
3, establish the concept of caring for children, empathy When scalp venipuncture, it is often necessary to shave off part of the hair to make the vein fully exposed and easy to fix, first seek the opinions of parents and try to meet the requirements of parents. If it is necessary to shave your hair, try to narrow it down, shave it backwards from the hair root, and cover the shaved part after infusion. After scalp acupuncture, it is often necessary to wrap adhesive tape around the head for fixation. In order to prevent the adhesive tape from sticking to the hair, we folded the adhesive surface of the middle part of the adhesive tape and took it off near the scalp along the direction of the hair at the end of infusion, which avoided the pain caused by pulling the hair and won the praise of children and parents. When puncturing hands and feet, we made love cardboard to fix the adjacent puncture parts of upper and lower joints to reduce the swelling of drum needles caused by joint activities. When the needle is pulled out, the method of continuous pressing is adopted, and it is instructed to press for 3 ~ 5 minutes without kneading, which not only avoids the bleeding and congestion at the eye of the needle caused by improper exchange pressing or insufficient time, but also protects the vein and is convenient for puncture again. These practices of caring for children everywhere are deeply welcomed by children and parents.
4. Strengthen nurse-patient communication and create a harmonious nurse-patient relationship. Parents are extremely anxious because their children are ill, eager for drugs to get rid of the disease, and they hit the nail on the head when asking for infusion. Therefore, with sympathy and understanding, we explain to them that "any disease has a process of occurrence, development and outcome" and tell parents that they will try their best to make their baby recover as soon as possible or use words such as "Don't worry, it will get better", "I will try my best to give you an injection" and "I really want to give you an injection" to comfort parents and reduce their anxiety, instead of "I don't know" and "I don't know". At the same time, parents should also have some predictive communication. For example, in the process of disease evolution, children with fever may have elevated body temperature or other symptoms, so parents should pay attention to it and inform them in time, and suggest that they have a thermometer at home, and handle it properly when the body temperature is too high to guide the physical cooling method; For some macrolides, gastrointestinal reactions may occur, and potassium-containing drugs may cause pain at the infusion site. After adjusting the dripping speed, tell parents not to adjust it at will, so as not to cause adverse reactions. Even if the above situation occurs, parents will understand and cooperate because of the pre-announcement. Praise your child with some words, such as "cute", "smart", "beautiful", "good skin" and "beautiful hair", praise some excellent aspects of your child, and then ask some children about their age, hobbies, diet and so on. Parents are generally willing to let their children cooperate with the treatment, and the relationship between nurses and patients will be more harmonious. After the infusion puncture is completed, instruct the children and their parents to prevent the secondary puncture pain caused by improper protection of grasping hands and touching heads, and inform them that it is most important to comfort the children. Without affecting the infusion, it can meet the requirements of some children, such as eating, changing posture, slapping and giving toys.
5, reasonable scheduling In the case of the same nurse, according to the season, analyze the number of children's infusion in unit time, as well as the workload and minimum time of a day, adjust working hours at any time, and rationally allocate nursing staff. Arrange sufficient personnel during peak hours, choose nurses with good puncture skills to take venipuncture classes, and at other times, young nurses will take venipuncture classes, with skilled and experienced nurses as guidance; Careful nurses with good physical strength arrange to patrol the hall. In short, we should make overall consideration when scheduling. According to the workload and nurses' strengths, we should arrange shifts reasonably, arrange rest properly, fully mobilize nurses' work enthusiasm, reduce nurses' work pressure, provide high-quality services for children with full spirit, ensure that every child can get timely treatment and prevent nurse-patient disputes.
Second, standardized operation and safe infusion
1, medicine nurses should check:
① First connection system: When receiving the patient's injection list and drugs, the nurse should first check all the drugs according to the single injection list, then check whether it is necessary to do an allergy test, and then check whether there are any compatibility taboos between the drugs. At the same time, check the general situation and disease diagnosis of the child at that time, judge whether emergency infusion is needed, explain the special drugs, and closely observe the changes of the condition.
(2) Responsibility system of signing for liquid preparation, infusion and bottle connection: Nurses must strictly abide by the system of three checks and eight pairs, strictly check and sign bottles after liquid preparation, and sign before puncture, when changing bottles and when pulling out needles, so as to clarify their responsibilities, ensure correct liquid input, and know what medicine is input and when it is lost when it is inappropriate, so as to handle it in time.
2. Strictly control the preparation time: strictly control the effective time after drug preparation. Antibiotics must be prepared now, and other drugs should be prepared at most 1 bottle in advance to avoid the decline of curative effect or adverse reactions caused by long-term storage of liquids.
3. Improve the record of skin test results: All drugs that need skin test should be marked with skin test results and signed on outpatient prescriptions and medical records. If the skin test is exempted according to the regulations, the basis of the last medication (outpatient medical record or prescription) must be checked, and the skin test should be re-done if the facts are unclear.
4, abide by the disinfection and isolation system, to prevent the occurrence of cross infection:
① Strictly abide by the operating rules of aseptic technology: strictly implement the principle of one person, one needle, one pulse pressure belt and one disinfection, and disinfect the infusion room and dispensing room with conventional air.
② The floor of the infusion hall and transfusion chair are routinely wiped twice a day, and the air is disinfected three times to prevent cross infection.
5. Strengthen the education of nursing safety precautions: stick eye-catching signs on the back of the infusion plate clip, such as: please don't leave the infusion hall when infusion; Please don't adjust the descending speed at will. In this regard, we have strengthened education through examples, and the phenomenon of leaving the hall without authorization has almost been eliminated.
6. Closely observe the changes of children's condition: children's diseases are often acute, rapid and serious, and children cannot express them correctly. Therefore, nurses should have a high sense of responsibility, patrol frequently, cultivate keen observation and master the pathophysiological characteristics of children. During the patrol, pay attention to the child's spirit, complexion, body temperature, pulse, breathing, facial expression and movements, and find abnormalities as soon as possible and deal with them in time. Adjust the drip rate according to the age, illness and medicine of the child to avoid excessive infusion in a short time, and inform the family members not to adjust the drip rate of infusion by themselves.
Third, strengthen self-cultivation and improve technical and psychological quality.
Strengthening the basic training of nurses and reducing children's pain is the most basic connotation of humanized nursing. Every nurse should be standardized, gentle, skilled and accurate in puncture, so as to minimize the pain and stimulation during puncture. Every Thursday, the department invites nurses with rich puncture experience, skilled skills and standardized operation to explain the precautions and puncture skills of special children, so as to improve the puncture skills of junior nurses. According to the particularity of pediatrics, roll call service is provided for children in need to improve the satisfaction of children and their families and reduce disputes.
Fourth, do a good job in health education and strengthen inspections.
Implement standardized management of intravenous infusion patrol, strengthen the systematization of intravenous infusion patrol, and patrol children with infusion at any time. The head nurse should patrol regularly every day (after work and before work) and at any time to find and deal with the problems in infusion in time. Actively carry out various forms of health education, such as health education bulletin boards, holiday seminars, knowledge lectures, etc. Provide personalized service for patients, introduce the functions and precautions of drugs for different individuals, and guide the relevant knowledge of diseases. In the process of infusion, the relationship between the puncture site and the patient's cooperation and the success of puncture was emphasized. During the patrol, it is necessary to strengthen education, inform patients of possible adverse drug reactions and precautions during infusion, patiently answer questions raised by children and parents, and carry out health education throughout every link of the infusion process, which not only meets patients' requirements for health knowledge, but also relieves their negative psychology.
I can hear this conversation in the infusion hall every day:
"It's time to take medicine. Shall we give the baby medicine? "
"Ok, thank you!"
"Sister Nurse, I don't feel well with this bottle of medicine."
"Oh, the medicine you take is azithromycin, which has gastrointestinal reaction. Come on, eat something and you'll feel better. "
"Today's performance is really good. Aunt rewards you and tells you a story, okay?"
"hmm"
"What stories do you like to hear?"
"Just tell the story of a little white rabbit."
……
Don't do small things with kindness. Every nurse in the infusion hall has been instilled with the concept of detail determinism, which has overcome the difficulties of heavy workload, high noise and high mobility of personnel and promoted high-quality nursing service. We implement norms in management, integrate harmony into service, unite as one, and strive to build a professional team with excellent business level under the leadership of the nursing department.