NICUにおけるルチーン採血の現状と課題 <原著>

本研究は, NICUにおけるルチーン採血の現状を調査し, 今後の課題を検討することを目的とした. 調査は構成型質問紙調査とし, 全国115施設のNICUにおけるルチーン採血の実情を記述的に分析した. その結果, ルチーン採血の一般的な状況は, 次のようにまとめることができた. すなわち, 1)採血は午前6時台から9時台までに医師が1人で実施, 2)採血部位は足底や手背で, 部位の選定基準は採血量, 3)採血用具は, 足底の場合はランセットよりも注射針, 手背は23ゲージ注射針, 4)採血部位は温めない, 5)痛み軽減への対処は泣くとおしゃぶりを与える(40%の施設), 6)現状に対して問題や課題があると認識していた.

これらの結果から, 採血方法, 足底採血の用具, 痛みの緩和法, 医師と看護師の協力という4側面が今後の課題として明らかになった.

The purpose of this study was to identify the present clinical issues about routine blood sampling in the NICU. A structured questionnaire was distributed to 201 NICU nurse managers and 115 valid responses were received (57.2%). Data were descriptively analyzed.

On the whole results were as follows: 1) Blood sampling was done by a neonatologist alone from 6am to 9am, 2) Site of blood sampling was chosen as heel or back of hand by blood sample volume, 3) Needle was more used than lancet for heelstick, and 23-gauge needle was used for collecting blood drops from vein of hand, 4) Warming of the site of blood sampling was not done, 5) Pacifier was used on crying for pain alleviation (40%), and 6) NICU nurse managers recognized the necessity of improvement of present condition.

Through the study results, four clinical issues were identified about routine blood sampling in the NICU: 1) Blood sampling method, 2) Heel lancing device, 3) Pain alleviation, 4) Collaboration between nurse and medical doctor.