Model essay on pediatric nursing-pediatric nursing
Infantile scalp intravenous infusion is the most basic and important basic skill in pediatric nursing. Pediatric nurses should not only have full enthusiasm, selfless love and strong sense of responsibility, but also have superb skills and rich experience, be good at summing up working methods and attach importance to children's psychological care.
Scalp venipuncture; Venous puncture; Suppression method; Talking about how to give toxic infusion to children's scalp in psychological nursing
Pediatric scalp intravenous infusion is one of the most basic and important basic skills of pediatric nursing. Pediatric nurses should not only have full enthusiasm, selfless love and strong sense of responsibility, but also have superb technology and rich experience, be good at summing up working methods and paying attention to children in their usual nursing work. Nursing psychology.
Keywords scalp venipuncture; Venous puncture; Stop method; Basic methods of psychological nursing for scalp venipuncture
1. 1 vascular selection: during the period from birth to 3 years old, there is little subcutaneous fat in the head, the veins are clear and shallow, and they are distributed in a network, and blood can return through collateral circulation. Therefore, children in this period should choose scalp venipuncture. Children aged 3 ~ 12 years old have thick subcutaneous fat, thick hair and unclear blood vessels, which is not conducive to scalp venipuncture. Anatomically speaking, the median frontal vein is shallow in fixation and thick in blood vessels, which is easy to puncture, but easy to leak during infusion, and is mainly used for children with little drug irritation and short infusion time; The supraorbital vein is shallow and clear, and it is not easy to leak during infusion. The anterior temporal vein and temporal vein are thick and deep, which are suitable for massive infusion and injection of irritating drugs.
1.2 light intensity: the brightness and irradiation angle of light directly affect the success rate of puncture. When the light is too strong, the pupil is narrowed, and the light is too weak, bright natural light is the most ideal light, the vein is clear, the operator's eyes are not easy to get tired, and the light is not good. Our department chooses two 30W fluorescent lamps, which are about 50cm away from the puncture vein in front of the operator to ensure sufficient lighting conditions.
Selection of 1.3 needles: For children from birth to 3 years old, scalp needles of 4 12 ~ 5 12 specifications are generally selected, and physiological saline is extracted with a 2 ~ 5ml syringe and connected with the scalp needles.
1.4 needle insertion technique: needle insertion hour and skin are 10 ~ 15? Angle, the inclined plane of the needle is upward, the right hand holds the needle, the left hand tightens the skin, and directly pierces the vein through the skin. After blood transfusion, it is not appropriate to re-input and fix it directly. If there is no blood return, pull the pin of the syringe needle with your right hand, and the blood can be returned after successful puncture.
1.5 needle fixation: after successful puncture, fix the needle handle with the left thumb and fix it with 3 ~ 4 pieces of adhesive tape; After winding, fix the scalp acupuncture pigtail on the auricle with 1 piece of short adhesive tape; The winding range of scalp acupuncture pigtail should not be too large to avoid being pulled off or knocked off during infusion; It is especially recommended to shave the hair around the puncture point before puncture, so as to facilitate adhesive tape fixation. If the child is crying or applying antipyretic drugs to cause excessive sweating in the head, the head circumference fixation method can be used. Connect the two ends of an elastic band with a length of 35 ~ 45cm and a width of 2 ~ 3cm, put it on the head and fix it on the adhesive tape at the puncture point, which can prevent the adhesive tape from falling off due to sweating and prevent the hair from sticking when pulling out the needle.
1.6 scalp venipuncture in obese children: The scalp veins of obese children are unclear and the scalp fat is thick, so it is difficult to grasp the depth of the needle. We have mastered the following three points to operate:
1.6. 1 veins are often exposed to the scalp edge of obese children, but the blood returns to the lumen slowly. When puncturing, it is required to slowly and steadily enter the needle. After feeling the needle enter the blood vessel, you can see the blood by pulling out the needle plug of the syringe, which proves that the puncture is successful.
1.6.2 According to the anatomical position of veins, can you touch the corresponding parts of blood vessels such as median frontal vein, anterior temporal vein and posterior auricular vein with your fingers? Groove marks? Feeling, touch? Groove marks? You can feel the direction and depth of the vein, and the needle insertion angle 15 ~ 20? The speed of needle insertion should be slow, and sometimes you will feel frustrated when you enter the vein. Seeing the blood returning, the puncture was successful.
1.6.3 children's skulls run along frontal suture, coronal suture, sagittal suture and herringbone suture. Find out the suture during puncture, and the needle insertion angle is 45 ~ 60? After the inclined plane of the needle enters the skin, it will pierce forward in parallel and can be fixed when returning blood.
2 Matters needing attention during venipuncture and infusion
2. 1 In the process of dispensing and puncture, operate in strict accordance with aseptic technical operation procedures.
2.2 Puncture can start from one end of the vein, retrograde or anterograde, and should not start from the middle of the blood vessel, in case of puncture failure, forming subcutaneous congestion, and the whole blood vessel is blurred, so it is impossible to puncture again.
2.3 The adhesive tape should be firm: when the hand is fixed, it cannot float on the skin, so that the needle will shift and pierce the blood vessel, causing local swelling.
2.4 Pay attention to the pressing method.
2.4. 1 When pulling out the needle, first separate the adhesive tape, put the sterilized cotton ball at the puncture site, and press the cotton ball longitudinally along the blood vessel direction with the left thumb to quickly pull out the needle, and press the needle eye at the same time to prevent subcutaneous congestion.
2.4.2 is formed by coagulation substances such as platelets? Physiological hemostasis? It takes 1 ~ 3 minutes, and the pressure in scalp blood vessels increases when the child cries because of pain and fear when pulling out the needle. It needs to be pressed for 3 ~ 5min minutes. Don't be soft when pressing. Kneading can make the needle eye of blood vessel bleed again, resulting in subcutaneous blood stasis.
2.5 Do a good job in publicity and education: tell the parents of children not to breastfeed and feed water before venipuncture, so as to avoid accidents caused by nausea, vomiting and suffocation due to crying during puncture. Before puncture, parents should be informed to help restrain the child's head and legs. One person can restrain the head, and the other person can restrain the knees. After successful puncture, you can hold the child in the posture of feeding, and properly restrain the child's hand to prevent the child from pulling out the needle.
2.6 In the process of infusion, it is necessary to strengthen patrol observation, and find that the child's complexion and consciousness change, the fixed belt is loose, the needle is displaced, and the local swelling, etc., and take timely measures to ensure the smooth infusion.
3 Psychological nursing
3. 1 environment and atmosphere: all nurses in our department wear light pink overalls and light pink swallow hats, and the sheets and curtains are light pink broken patterns, which are well ventilated and brightly lit, creating a lively, pleasant, relaxed and cordial environment and giving people a warm and pleasant feeling.
3.2 Take advantage of the characteristics that children's attention is easily diverted and they like praise and encouragement, appease and Doby children before puncture, eliminate their strangeness and fear with soft tone, gentle language, patience and kindness, and try to alleviate their pain and crying. When a child cries, you can pat him gently and touch his cheeks, limbs, etc. And comfort them kindly and gently, and care and care for their injured little hearts with love.
4. Improve the psychological quality of nurses.
4. 1 Improve self-cultivation and understand the mood of family members: When the child cries, the parents of the child are nervous, distressed and impulsive, and the excited mood will interfere with the operation of the nurse. Therefore, as a nurse, we should understand parents' feelings, use our broad love and tolerance to understand and tolerate children's parents' excessive language and behavior, and use gentle language to resolve parents' anxiety.
4.2 Overcome impatience and improve resilience: Nurses must maintain a stable psychological state during the operation, pay attention, be calm and unhurried, eliminate interference, steal time from work, and strive to achieve 1 successful puncture.
4.3 Have a high sense of responsibility: establishing a high sense of responsibility is conducive to nurses to strengthen their study, sum up experience, and work carefully, which is conducive to improving nurses' professional skills and improving the success rate of venipuncture.
5 abstract
Intravenous infusion in children is one of the important ways of clinical medication, and it is also an important means to rescue critically ill children. It is an indispensable basic operation in pediatric nursing, and its level is directly related to medical quality, children's rehabilitation and nurse-patient relationship. At the same time, constantly improving the psychological quality and self-cultivation of nurses at work can not only improve the success rate of scalp venipuncture in children, improve the quality of nursing, but also improve the relationship between doctors and patients.
Model essay 2 on pediatric nursing teaching reform.
Due to the lack of typical cases of some unique diseases in clinic, such as severe malnutrition, hypertonic dehydration and diarrhea, and the lack of typical cases and even related patients in clinical probation, the phenomenon that the teaching content is out of touch with clinical diseases is particularly prominent. In the limited teaching time, it is an arduous task for every teacher to teach pediatric nursing well and coordinate the contradiction between teaching content and clinical probation.
Keywords pediatric nursing reform and construction
Due to the lack of typical cases of some unique diseases in clinic, such as severe malnutrition, hypertonic dehydration and diarrhea, and the lack of typical cases and even related patients in clinical probation, the phenomenon that the teaching content is out of touch with clinical diseases is particularly prominent. In the limited teaching time, it is an arduous task for every teacher to teach pediatric nursing well and coordinate the contradiction between teaching content and clinical probation. In order to get rid of the difficulties faced by pediatric nursing teaching and cultivate students' innovative thinking ability and comprehensive analysis ability,
The following is my attempt to reform the contents, methods and means of pediatric nursing teaching:
1 textbook construction
At present, the textbook Pediatric Nursing used by nursing students in our school is published by People's Health Publishing House. In the future, pediatric experts, professors and head nurses in our school should strive to compile a textbook of pediatric nursing suitable for nursing colleges. Based on the transformation of modern medical model and the clinical and teaching practice of nursing, this book focuses on the diagnosis, treatment principles and nursing measures of diseases, emphasizing the idea and principle of taking patients as the center and benefiting holistic nursing.
2. Construction of teaching staff
In the past, the pediatric care of nursing college students was undertaken by teachers in the pediatric teaching and research section of nursing department.
In the future, we should have our own full-time pediatric nursing teachers, make full use of clinical nursing teaching strength and hire some experienced part-time teachers, which not only solves the problem of insufficient full-time nursing teachers, but also gives full play to the role of clinical frontline nursing staff in teaching. Part-time nursing teachers should give trial lectures before each lecture, and the teaching team leader should strictly check to ensure the teaching quality.
3 Teaching content update
In the past, the teaching of pediatric nursing was mainly theoretical teaching and production practice, which was out of touch with clinical practice.
3. 1 Adjust the teaching content in detail, such as general introduction, common neonatal diseases, vitamin D deficiency rickets, diarrhea, bronchopneumonia, etc. For some rare diseases in clinic, we should give full play to students' subjective initiative and let them learn by themselves, such as nursing children with genetic diseases and infectious diseases; At the same time, lectures on children's common psychological problems and children's learning difficulties are held to supplement the lack of learning content. It is a subject that studies the law of children's growth and development, child health care, disease prevention and clinical nursing, so that students can systematically understand pediatric nursing in a short time [1].
3, 2 supplement the practice content, enhance students' practical ability. First of all, the internship plan should be made carefully, and the teaching content should be refined to meet the needs of clinical nursing work. Increase the use methods and indications of commonly used pediatric instruments, and the teacher introduces them while operating. Such as blue light irradiation box, warm box, ultrasonic atomization therapeutic instrument, etc. , so that students can increase the chances of hands-on operation and lay a good foundation for early clinical practice. At the same time, students are arranged to go to the community kindergarten 1 time, and children of different ages are measured and given a preliminary evaluation, and a physical examination report is written. In addition, students are arranged to visit 1 time, mainly children's specialized hospitals, so as to deepen their understanding of the present situation and development of pediatric nursing.
4 update of teaching methods and means
After strengthening the reform of clinical thinking, in addition to the original traditional teaching, case discussion class, self-study class and lecture class were added, and various teaching forms were used to cultivate students' clinical thinking ability and illness judgment ability.
4. 1 Concentrate on collecting teaching pictures in time, and pay attention to the key points and difficulties when listening to lectures. The teaching forms are multimedia slides, VCD of related diseases, videos, models or various typical teaching pictures at home and abroad. This kind? From image to image? The new teaching method can deepen students' deep memory of classroom content, and can also supplement the shortage of clinical cases. After each class, 2 ~ 3 simple cases are arranged to be discussed in groups according to what they have learned, which can improve students' interest in learning pediatrics and their initiative to participate actively.
4.2 case discussion class 1 ~ 2 case discussion class is organized throughout.
1 week Distribute medical history abstracts to students before class, with 6-8 people in each group, and prepare the medical history, diagnosis, treatment principles and nursing measures of the cases as required. Then, in the class, the representatives of each group of students will speak on the stage, and the cases will be analyzed and judged 10 minutes. Other students asked the speaker questions, and then the teacher summarized the characteristics of the case history and introduced the clinical diagnosis and nursing measures. The last lecture time is 2 hours around the disease. Through case discussion class, students learn to collect clinical data and find problems in disease diagnosis and nursing. At the same time, students' learning ability, language expression ability, clinical thinking ability and improvisation ability have all been improved. It not only consolidates the learned knowledge, but also can guide clinical practice with the learned knowledge.
4.3 Self-study course: Pediatrics has a lot of content, due to limited class hours. Some content can only be taught by yourself. For some chapters of common inpatient diseases in pediatrics, we mainly adopt the way of self-study, and give some thinking questions according to the characteristics of diseases, so that students can learn by themselves with questions, and teachers can give guidance at any time, so as to cultivate students' self-study ability and improve the level of summarization and induction. Through self-study, students not only learn knowledge, but also improve their self-study ability, changing passive learning into active learning.
4.4 Carry out the second class to understand the subject dynamics. In order to meet the needs of students with learning ability, combined with the professional characteristics of teachers in the teaching and research section, a special lecture on children's health care was held to explain the cultivation of children's good habits, the cultivation of social adaptability and the prevention of accidents. Special lecture on children's psychology, teaching children's common psychological problems and behavioral problems, emotional problems, hyperactivity syndrome and other intervention measures. Let students understand and pay attention to the comprehensive problems of children's health from simple physical health to physical health, mental health and sound social function, and better implement the leading idea of holistic nursing.
4.5 The reform of assessment methods used to be mainly theoretical examinations, often? Take notes in class, read notes after class, and take notes in exams? In exam-oriented education, students can't skillfully use what they have learned immediately when they enter clinical practice. After the reform, the theoretical test score is 60%, and the target level in the cognitive field is assessed, that is, memory, understanding, application, analysis and comprehensive ability. Among them, the basic level goal (understanding+memory accounts for 2/3) and the high level goal (comprehensive analysis accounts for 1/3) are set to evaluate students' cognitive level. The score of nursing operation is 30%, including nursing techniques commonly used in pediatrics, such as the measurement of children's growth and development indicators, scalp intravenous injection, drug feeding methods for children, operation and indications of incubators and blue light boxes. Comprehensive quality score 10%, including answering questions in class, telling cases, writing physical examination reports, caring about injuries and learning initiative. This evaluation method can not only objectively reflect students' cognitive level and skill level, but also reflect students' comprehensive quality.
Combining with the development of pediatrics, reasonably adjusting the curriculum and adopting various teaching methods and means not only retains the advantages of traditional teaching in knowledge transmission, but also embodies the student-centered teaching policy, cultivates students' innovative thinking ability and comprehensive analysis ability, and constantly explores new methods and new ways of pediatric nursing clinical teaching, laying a solid foundation for the upcoming clinical work.
References:
1. Haddy Fan, nursing of hospitalized children. Pediatric Nursing, 2007
Recommendation of pediatric nursing demonstration articles
1. Model essay on pediatric nursing
2. Model essay of pediatric nursing undergraduate graduation thesis
3. Pediatric nursing paper model essay daquan
4. Pediatric nursing papers
5. Talking about the model essay of pediatric nursing.
6. Pediatric nursing model essay
7. Undergraduate thesis of pediatric nursing.