A questionnaire survey on nursing situations for pediatric patients with respiratory diseases and the status of use of severity scales
| Autor: | Kuroiwa, Shiki, Kawahata, Hirohisa, Aoki, Motokuni, Sakai, Norio |
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| Jazyk: | japonština |
| Rok vydání: | 2020 |
| Předmět: | |
| Zdroj: | 森ノ宮医療大学紀要. 15:29-42 |
| Popis: | 呼吸器疾患罹患患児に対する看護の現状把握を目的とし、特に重症度スコア使用状況に着目しつつ、 医療機関検索サイトより抽出した小児科を標榜し、二次救急受け入れ可能な病院 629 施設にアンケー ト調査を実施した。小児病棟設置施設は 41.3% にとどまり、また重症化による高次病院搬送は 69.6% であり、少子高齢化社会における小児入院可能施設減少状況や救急医療体制の問題が反映された結果と なった。呼吸器疾患罹患患児に対する看護(複数回答)では、観察項目として努力性呼吸(76.1%)・ SpO2 値(69.6%)・呼吸数(32.6%)が重要視され、この3項目を選択しない施設は 2.2% のみであっ た。呼吸の状態悪化と判断した場合の看護(複数回答)では酸素投与、薬剤の吸入、鼻汁・痰の吸引が 90%以上の施設で実施され、SpO2 値 94%~ 95%で酸素投与を開始する施設が 43.4% で最多であった が、酸素投与開始基準については小児医療の中で統一されていない現状であった。重症度スコア利用に よる総合的判断を看護アセスメントに活用している施設は 17.4% と低い現状であった。 In this study, a questionnaire survey was performed to reveal nursing situation for pediatric patients with respiratory diseases and to investigate status of use of severity scales for respiratory diseases. Only 41.3% of hospitals that answered the questionnaire secured a pediatric ward, and 69.6% were forced to transfer to other hospitals for severe cases, suggesting shrinking pediatric medical environment in an aged society. Concerning survey about observation parameters in nursing for pediatric patients with respiratory diseases, effort breathing, degree of oxygen saturation and respiratory rate were regarded as important parameters. Although almost hospitals performed oxygen administration for severe cases, our questionnaire survey showed that oxygen start criteria was not unified. Hospitals that use severity scales for respiratory diseases in nursing assessment were only 17.4%, and there was no difference in use rate between a pediatric ward and a mixed ward. Also, expertise, hospital scale and medical standards of hospital did not affect to use rate of the severity scales. This questionnaire survey suggested decline of pediatric medical care. Although comprehensive observation should be essential in nursing for early detection of respiratory disorder of pediatric patients, this survey revealed limited use of severity scores which could contribute to improve the quality of nursing assessment. It is expected to evaluate usefulness of severity scales in nursing field, and to spread the use of scores. |
| Databáze: | OpenAIRE |
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