儿科流体管理的挑战:护理实践和知识的洞察
Amir Shahzeydi1,2, Faramarz Kalhor3,4, Mahboobeh Namnabati3
1Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Sage open pediatrics
|September 4, 2025
概括
在儿科药物稀释中过多的液体可能会伤害患者. 标准化指导方针和改善护士教育对于防止流体过载和提高新生儿和儿科护理的结果至关重要.
科学领域:
- 儿童重症监护医疗
- 护士实践和患者安全
- 药理学和药物管理
背景情况:
- 在儿科和新生儿重症监护室, 流体过载是一个很大的风险.
- 在药物稀释过程中过度注射液体会导致严重的并发症,包括急性损伤 (AKI),呼吸时间延长和死亡率增加.
- 目前的药物稀释实践可能无法充分应对易受影响的儿童群体的液体过载风险.
研究的目的:
- 评估当前在儿科和新生儿环境中在药物稀释过程中使用液体的做法.
- 评估护士在药物稀释和流体管理方面的知识和表现.
- 确定预防儿科患者过度流体负荷的关键领域.
主要方法:
- 2024年涉及14个儿科单位 (PICU,NICU,外科/普通病房) 的横截面研究.
- 直接观察150名患者和200名护士使用8种常见药物.
- 通过检查清单和问卷收集有关液体量,输液持续时间,药物兼容性和储存规范的数据.
主要成果:
- 护士的整体知识得分为中等 (68.3%),各单位的差异很大.
- 在PICU (76. 0%) 的表现最高,在外科病房 (62. 86%) 的表现最低.
- 确定的问题包括常见抗生素 (万科米辛,安培西林,) 的过度稀释和存储不良 (40%在心脏NICU).
结论:
- 标准化稀释指南对于减轻液体过载风险至关重要.
- 对护理人员来说,提高药物兼容性,储存和流体管理的教育至关重要.
- 实时监测工具的实施可以支持更安全的药物管理,并改善儿科患者的治疗结果.
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