基于循证的新生儿足底采血疼痛综合管理的临床实践  

Clinical practice of intergrated management of pain in plantar blood collection of newborn based on evidence

作　　者：冉琼[1] 刘小梅 唐佳玉 唐婕[1] 陈洁[1] 杨红[1] 黎凡[1] 曹佳 陈冬梅[1] 朱宏蛟 王英[1] RAN Qiong;LIU Xiaomei;TANG Jiayu;TANG Jie;CHEN Jie;YANG Hong;LI Fan;CAO Jia;CHEN Dongmei;ZHU Hongjiao;WANG Ying(Dazhou Central Hospital,Sichuan 635000 China)

机构地区：[1]达州市中心医院,四川635000

出　　处：《循证护理》2023年第14期2514-2517,共4页Chinese Evidence-Based Nursing

基　　金：达州市中心医院2022年度院级科研项目,编号:2022YJ12。

摘　　要：目的:基于最佳证据建立新生儿足底采血疼痛护理方案,探讨其临床实践效果。方法:采用复旦大学循证护理中心的“基于证据的持续质量改进模式图”,于2020年3月—8月进行证据获取、现状审查、证据引入及效果评价4个步骤,将循证实践方案应用于我院产科病房新生儿足底采血中,比较证据应用前后助产士的新生儿疼痛知识水平和一次采血成功率、新生儿疼痛程度和啼哭时长等。结果:循证实践项目采用了9条证据。证据应用后2名助产士的新生儿疼痛知识得分由应用证据前的65分提高为100分,应用证据后质量审查标准2~4均由证据应用前的0上升为100%,证据应用后干预组一次采血成功率(97%)高于对照组(78%),证据应用后干预组疼痛评分、啼哭时长低于对照组,差异均有统计学意义(P<0.05)。结论:综合管理干预措施可减轻新生儿疼痛程度,为新生儿提供舒适性照护。Objective:Based on the best evidence,to establish the nursing plan of pain in plantar blood collection of newborn,and to discuss its clinical effect.Methods:The"Evidence based Continuous Quality Improvement Model Map"of the Evidence Based Nursing Center of Fudan University was used to carry out four steps of evidence acquisition,status review,evidence introduction and effect evaluation from March to August 2020,and the evidence-based practice program was applied to the foot blood collection of newborns in the obstetric ward of our hospital.To compare the scores of NIPS and the success rate of one-time blood collection among midwives before and after the application of evidence,as well as the degree of neonatal pain during the operation and the duration of neonatal crying.Results:The evidence-based practice project adopted 9 pieces of evidence.After the application of evidence,the scores of NIPS of the two midwives increased from 65 points before the application of evidence to 100 points;After the application of evidence,the quality review standards 2-4 have all increased from 0 before the application of evidence to 100%;After the application of evidence,the success rate of one-time blood collection in the intervention group(97%)was higher than that in the control group(78%).After the application of evidence,the NIPS score and crying duration in the intervention group were lower than those in the control group,and the difference was statistically significant(P<0.05).Conclusions:Comprehensive management intervention measures can reduce the pain level of newborn blood collection and provide comfortable care for newborn.

关 键 词：新生儿 足底采血 疼痛管理 循证实践 护理 

分 类 号：R473.72[医药卫生—护理学]