在CT室进行颈外静脉穿刺培训方法探讨
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摘要
目的:探讨CT室护士通过不扎止血带的静脉穿刺培训后,延伸到颈外静脉穿刺的方法。方法:2017年1月开始,在有经验的老师指导下,进行不扎止血带的静脉穿刺培训,培训学员达到连续50例不扎止血带的静脉穿刺一次性成功率100%,参加颈外静脉穿刺培训,在颈外静脉穿刺的培训指导3次以上,在有穿刺经验高年资护士在旁辅助指导下,方可独立操作,逐步过渡到单独操作。分别观察参训护士连续50例不扎止血带的静脉穿刺一次性成功率达到100%所需时间、首次进行颈外静脉穿刺时间、1～7月CT室行颈外静脉穿刺一次性成功率、对比剂渗漏发生率、图像质量。结果:三名护士达到连续50例不扎止血带的静脉穿刺一次性成功率100%的时间分别为34、42、56天;三名护士首例颈外静脉穿刺均取得一次性成功;颈外静脉穿刺一次性成功率达100%;无对比剂渗漏发生;图像质量均达到诊断的要求。结论:在有经验的老师指导下,通过不扎止血带行静脉穿刺培训,过渡到颈外静脉穿刺的实践方法,具有科学性,实用性,可作为CT室护士分级培训的一项内容,有利于提高护士的护理技能及工作热情,为CT增强检查时静脉穿刺困难的患者提供安全预案,更好地服务于患者。
Objective To discuss the way the nurse in the CT room extends to the external jugular vein through the training of venous perforation without a bandage. Method In January 2017, in under the guidance of experienced teacher, don't plunge into a tourniquet venipuncture training, training students to achieve continuous 50 cases not firm tourniquet venipuncture one-time success rate of 100%, external carotid venipuncture training, train the outside the neck vein puncture in the above 3 times, in the piercing experience high qualification nurses in the auxiliary guidance, can the independent operation, gradually transition to a single operation. Respectively to observe the participation nurse for 50 cases of not firm tourniquet venipuncture time needed for one-time success rate of 100%, for the first time for external carotid vein puncture time, July 1-CT room with external carotid venous puncture one-time success rate, incidence of leakage of contrast medium and image quality. Results The success rate of the three nurses was 34, 42 and 56, respectively. The first three nurses were successful in the first time. The one-time success rate of the jugular vein puncture was 100%; No contrast agent leakage occurs; The image quality all meets the requirement of diagnosis. Conclusion In under the guidance of experienced teacher, by not firm tourniquet line venipuncture training, transition to the practice of external carotid vein puncture method, has the scientific, practical, can be used as a CT room nurse grading training content, to improve the nursing skills and work enthusiasm, for CT enhancement venipuncture difficulty of patients to provide a safe plan, better service to patients.
Objective To discuss the way the nurse in the CT room extends to the external jugular vein through the training of venous perforation without a bandage. Method In January 2017, in under the guidance of experienced teacher, don't plunge into a tourniquet venipuncture training, training students to achieve continuous 50 cases not firm tourniquet venipuncture one-time success rate of 100%, external carotid venipuncture training, train the outside the neck vein puncture in the above 3 times, in the piercing experience high qualification nurses in the auxiliary guidance, can the independent operation, gradually transition to a single operation. Respectively to observe the participation nurse for 50 cases of not firm tourniquet venipuncture time needed for one-time success rate of 100%, for the first time for external carotid vein puncture time, July 1-CT room with external carotid venous puncture one-time success rate, incidence of leakage of contrast medium and image quality. Results The success rate of the three nurses was 34, 42 and 56, respectively. The first three nurses were successful in the first time. The one-time success rate of the jugular vein puncture was 100%; No contrast agent leakage occurs; The image quality all meets the requirement of diagnosis. Conclusion In under the guidance of experienced teacher, by not firm tourniquet line venipuncture training, transition to the practice of external carotid vein puncture method, has the scientific, practical, can be used as a CT room nurse grading training content, to improve the nursing skills and work enthusiasm, for CT enhancement venipuncture difficulty of patients to provide a safe plan, better service to patients.
引文
[1]梁雪芬,李素琳,洪蝶玫.神经内科患者静脉穿刺困难的原因分析及对策[J].中华现代护理,2010,16(24):2961.
[2]李雪,张伟国,刘霞等,颈外静脉高压注射碘对比剂安全性的评价[J].中华现代护理杂志,201.18(19):2268-2271.
[3]乔毅,魏凤霞,李瑞敏.颈外静脉穿刺置管在院前急危重症患者急救中的应用.Journal of Clinical and Experimental Medicine Vol.10,No.2 Jan.2011:146,152.
[4]许丽桂.100例颈外静脉穿刺术分析[J].医药世界,2005,(12):62-63.
[5]毛翠秧.按压胸锁乳突肌颈外静脉穿刺法在呼吸困难患者中的应用[J].浙江实州医学,2009,14(1):80-81.
[6]戚晓梅,任国琴,丁新红.胸腔负压增高法用于颈外静脉置管术中的效果观察[J].护理与康复,2013,12(11):1062-1063.
[7]贾利红.提高颈外静脉隐匿患者留置针穿刺成功率的体会.当代护士,2013,12:126-127.
[8]李冬梅,覃小娟,高妍.两种压迫方法在乳腺癌肥胖患者颈外静脉穿刺中的应用[J].护理实践与研究,2013,10(5):113-114.
[2]李雪,张伟国,刘霞等,颈外静脉高压注射碘对比剂安全性的评价[J].中华现代护理杂志,201.18(19):2268-2271.
[3]乔毅,魏凤霞,李瑞敏.颈外静脉穿刺置管在院前急危重症患者急救中的应用.Journal of Clinical and Experimental Medicine Vol.10,No.2 Jan.2011:146,152.
[4]许丽桂.100例颈外静脉穿刺术分析[J].医药世界,2005,(12):62-63.
[5]毛翠秧.按压胸锁乳突肌颈外静脉穿刺法在呼吸困难患者中的应用[J].浙江实州医学,2009,14(1):80-81.
[6]戚晓梅,任国琴,丁新红.胸腔负压增高法用于颈外静脉置管术中的效果观察[J].护理与康复,2013,12(11):1062-1063.
[7]贾利红.提高颈外静脉隐匿患者留置针穿刺成功率的体会.当代护士,2013,12:126-127.
[8]李冬梅,覃小娟,高妍.两种压迫方法在乳腺癌肥胖患者颈外静脉穿刺中的应用[J].护理实践与研究,2013,10(5):113-114.