靜脈輸液操作規(guī)范手冊(cè)

目 錄 章 制度職責(zé)   1
一、靜脈輸液治療小組組織架構(gòu)............................................................... 1
二、靜脈輸液治療專科護(hù)士準(zhǔn)入制度........................................................ 1
三、靜脈輸液治療專科護(hù)士職責(zé)............................................................... 2
四、靜脈輸液治療小組成員管理規(guī)范........................................................ 2
五、靜脈輸液治療小組護(hù)理會(huì)診制度........................................................ 3
 
第二章 輸液工具的選擇及應(yīng)用原則....................................................... 4
一、外周靜脈輸液工具的分類................................................................... 4
二、外周穿刺工具的應(yīng)用原則................................................................... 4
三、經(jīng)外周置入中心靜脈導(dǎo)管應(yīng)用原則..................................................... 5
四、輸液接頭應(yīng)用原則............................................................................. 6
五、敷料應(yīng)用原則.................................................................................... 6
六、沖封管定義........................................................................................ 7
七、沖封管的應(yīng)用原則............................................................................. 7
八、導(dǎo)管拔除原則.................................................................................... 7
九、輸液港的日常維護(hù)............................................................................. 8
 
第三章 輸液治療相關(guān)并發(fā)癥預(yù)防及處理原則..................................... 10
一、導(dǎo)管堵塞的預(yù)防及處理原則............................................................. 10
二、靜脈炎的預(yù)防及處理原則................................................................. 10
三、藥物的滲出與外滲的預(yù)防及處理原則............................................... 13
四、導(dǎo)管相關(guān)性靜脈血栓的預(yù)防及處理................................................... 14
五、導(dǎo)管相關(guān)血流型感染的預(yù)防及處理原則............................................ 15
六、導(dǎo)管斷裂的預(yù)防及處理原則............................................................. 16
七、導(dǎo)管脫出移位的預(yù)防及處理原則...................................................... 17
八、PICC穿刺點(diǎn)感染的預(yù)防及處理......................................................... 17
 
第四章 職業(yè)防護(hù)..................................................................................... 18
一、職業(yè)安全防護(hù)原則........................................................................... 18
二、職業(yè)安全防護(hù)的基本措施................................................................. 18
三、意外暴露后的處理........................................................................... 19
四、醫(yī)務(wù)人員手衛(wèi)生規(guī)范........................................................................ 19
 
第五章 操作流程..................................................................................... 21
一、靜脈采血流程圖............................................................................... 21
二、動(dòng)脈采血流程圖............................................................................... 22
三、靜脈輸血流程圖............................................................................... 23
四、外周靜脈留置針操作流程圖............................................................. 24
五、超聲引導(dǎo)下PICC置管流程圖............................................................ 26
六、PICC換藥流程圖.............................................................................. 28
七、PICC拔管流程圖.............................................................................. 30
八、沖封管操作流程圖........................................................................... 32
九、靜脈輸液港維護(hù)流程圖.................................................................... 33
十、靜脈輸液港拔管流程圖.................................................................... 35
 
第六章 評(píng)分標(biāo)準(zhǔn)..................................................................................... 37
一、靜脈采血操作方法及評(píng)分標(biāo)準(zhǔn).......................................................... 37
二、動(dòng)脈采血操作方法及評(píng)分標(biāo)準(zhǔn).......................................................... 38
三、密閉式靜脈輸血操作方法及評(píng)分標(biāo)準(zhǔn)............................................... 40
四、沖封管操作方法及評(píng)分標(biāo)準(zhǔn)............................................................. 41
五、靜脈留置針輸液操作方法及評(píng)分標(biāo)準(zhǔn)............................................... 42
六、PICC維護(hù)評(píng)分標(biāo)準(zhǔn).......................................................................... 44
七、PICC導(dǎo)管撤除操作方法及評(píng)分標(biāo)準(zhǔn).................................................. 46
八、超聲引導(dǎo)下PICC置管方法及評(píng)分標(biāo)準(zhǔn).............................................. 48
九、靜脈輸液港維護(hù)評(píng)分標(biāo)準(zhǔn)................................................................. 49
十、靜脈輸液港拔除蝶翼針評(píng)分標(biāo)準(zhǔn)...................................................... 51
第七章 輸液安全管理............................................................................. 53
一、靜脈輸液治療質(zhì)控標(biāo)準(zhǔn).................................................................... 53
二、 輸液安全告知單............................................................................. 55
三、經(jīng)外周穿刺中心靜脈置管術(shù)（PICC）知情同意書............................. 57
四、深靜脈穿刺術(shù)知情同意書................................................................. 58
五、經(jīng)外周穿刺中心靜脈置管（PICC）帶管離院告知書......................... 59
六、實(shí)施管路拔除知情同意書................................................................. 61
七、化療患者拒絕行靜脈置管術(shù)知情同意書............................................ 62
八、病人發(fā)生輸液反應(yīng)時(shí)的應(yīng)急程序...................................................... 63
九、病人發(fā)生靜脈空氣栓塞的應(yīng)急程序................................................... 64
十、輸液過程中出現(xiàn)肺水腫的應(yīng)急程序................................................... 64
十一、 病人發(fā)生化療藥物外滲時(shí)的應(yīng)急程序.......................................... 65
十二、中心靜脈置管脫落的應(yīng)急預(yù)案...................................................... 65
十三、PICC導(dǎo)管脫出的應(yīng)急預(yù)案............................................................ 66
十四、留置針常見問題解答.................................................................... 69
十五、PICC導(dǎo)管維護(hù)技術(shù)....................................................................... 71
 
附 錄......................................................................................................... 77
試題一.................................................................................................... 77
試題二.................................................................................................... 91
試題三.................................................................................................. 106
試題四.................................................................................................. 118