在智力障碍的儿童和年轻人中开发基于社区的静脉穿刺护理模式:一项回顾性研究
Pankaj Garg1,2, Larissa Passarello3, Catherine O'Hea2
1University of New South Wales, Sydney, New South Wales, Australia pankaj.garg@health.nsw.gov.au.
BMJ paediatrics open
|August 3, 2024
概括
一种新的护理模式成功地为智力/发育障碍 (ID/DD) 和具有挑战性行为 (CBs) 的儿童和年轻人提供了血液采集. 这种方法,使用合理的调整和镇静剂,在非医院环境中实现了高静脉穿刺成功率.
科学领域:
- 儿科健康 儿科健康
- 提供残疾人服务.
- 医疗程序 医疗程序
背景情况:
- 血液检查对于监测代谢副作用至关重要,但对于智力/发育障碍 (ID/DD) 和挑战性行为 (CB) 的人来说具有挑战性.
- 现有的医疗保健途径往往无法满足这一群体对常规静脉穿刺的独特需求.
研究的目的:
- 开发和评估一种专门的护理模式,以促进ID/DD和CB的儿童和年轻成年人成功进行静脉穿刺.
- 改善弱势患者群体获得基本医疗监测的机会.
主要方法:
- 设计了一个系统的,分层的护理模式,结合了"合理的调整",如社交故事,分心和低感官策略.
- 与社区病理学服务提供商建立了合作伙伴关系.
- 一项观察性回顾性研究分析了人口统计数据,残疾严重程度,镇静要求和静脉穿刺结果.
主要成果:
- 在学校诊所对14名儿童 (平均年龄12.8岁) 进行了17次静脉穿刺试验,使用合理的调整和口服镇静,成功率达到82%.
- 在更广泛的环境中,在16个个体 (平均年龄为17.3岁) 的18次尝试中,成功率为77.7%.
- 31.4%的手术只需要合理的调整才能成功,而45.7%的手术需要有意识的口服镇静.
结论:
- 一个富有同情心,无压力的静脉穿刺护理模式已成功为残疾儿童和年轻人开发.
- 这项研究表明,静脉穿刺可以在非医院环境中有效地进行,对于被认为"在采血方面具有挑战性"的ID/DD和CB患者.
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