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静脉留置针贴膜应该怎么贴？你的做法很可能是错的

2018-10-29 阳光里的明媚 中国护理管理

静脉留置针贴膜护理操作
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实习护士小高刚刚轮转到我科，在一次为患者穿刺静脉留置针时，带教老师边穿刺边讲解，固定完毕，离开病房后，小高悄悄的问老师说：“以前在上一个科室实习时，老师固定静脉留置针时，透明敷料都是竖型固定的，说这样固定留置针的隔离塞就很容易被贴膜覆盖住。”说着，小高还拿出了固定的图片给老师看。那么，静脉留置针固定时到底贴膜是竖着还是横着固定呢？静脉留置针的白色隔离塞必须被贴膜覆盖吗？

案例一

实习护士小高刚刚轮转到我科，在一次为患者穿刺静脉留置针时，带教老师边穿刺边讲解，固定完毕，离开病房后，小高悄悄的问老师说：“以前在上一个科室实习时，老师固定静脉留置针时，透明敷料都是竖型固定的，说这样固定留置针的隔离塞就很容易被贴膜覆盖住。”说着，小高还拿出了固定的图片给老师看。那么，静脉留置针固定时到底贴膜是竖着还是横着固定呢？静脉留置针的白色隔离塞必须被贴膜覆盖吗？

案例二

近日，在医院护理群内，一位护理人员说：“今天护理部质控人员来我们科室，说静脉留置针贴膜上没标注穿刺的具体时间，是不是太那个了？我们每天晨交班查房时都查看，不超过4天就行了呗，唉！说多了都是泪。另外再咨询一下，留置针穿刺时必须戴手套吗？”

针对以上两个案例，笔者查阅了一些相关资料，共同分享如下。

1、静脉留置针固定时贴膜到底是竖着还是横着固定呢？

王春英、徐军等主编的《实用护理技术操作规范与图解》静脉留置针的固定方法中讲到：无菌透明敷料采用无张力、竖向或横向塑型密闭式固定。说明只要穿刺点位于贴膜的中央部位，根据患者的穿刺部位采用横向或竖向贴膜固定都是可以的。

2、透明敷贴必须将静脉留置针的白色隔离塞完全覆盖吗？

是的。

《实用护理技术操作规范与图解》中也提到，透明敷贴应将留置针的白色隔离塞完全密闭。

3、贴膜维护标签上维护时间到底用不用具体到时刻？

用的。

赵改婷、孙秀梅主编的《静脉治疗护理技术操作手册》外周静脉留置针的固定中提到采用高举平台法固定肝素帽，并在透明敷料上注明穿刺日期、时间及穿刺者姓名。

《实用护理技术操作规范与图解》要求在标签纸上记录穿刺日期、时间及穿刺者姓名。

4、外周静脉留置针穿刺时必须戴无菌手套吗？

不用。

中华人民共和国行业标准《静脉治疗护理技术行业规范》中 6.1.6中强调，置入PVC时宜带清洁手套，为了减少医务人员职业暴漏的风险，标准推荐使用清洁手套，但不使用也是合法的。

5、静脉留置针标准固定法

步骤一：将穿刺点置于透明敷料的中心位置，横向或竖向无张力粘贴、塑型，并将留置针的白色隔离塞完全密闭。

步骤二：在标识贴上写明置管日期、时间及签名，并将标识贴粘贴到留置针的白色隔离塞处。

步骤三：留置针接头高于穿刺点、U型固定且与血管平行固定，旋紧肝素帽和白色隔离塞。

步骤四：连接输液器头皮针，胶布交叉或一字型固定到皮肤上（如为正压接头则连接紧密），胶布不得直接粘贴到肝素帽或正压接头上。

步骤五：带吸水垫的输液贴覆盖肝素帽或正压接头。

本人认为，只要是穿刺点在贴膜中央，贴膜能完全覆盖注静脉留置针的白色隔离塞，无论贴膜是横着、竖着或倾斜都是可以的。

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    2021-05-17 ms5000001455536924

    谢谢分享

    0

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    2019-04-25 xuyong532

    #留置#

    0

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    2019-07-25 fusion

    #静脉#

    0

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    2018-10-31 chshh81

    #留置针#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=966226, encodeId=40ee966226b3, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d9ee5380218, createdName=ms5000001455536924, createdTime=Mon May 17 11:22:00 CST 2021, time=2021-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1670097, encodeId=bbb416e0097fa, content=<a href='/topic/show?id=809ce0322c0' target=_blank style='color:#2F92EE;'>#留置#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70322, encryptionId=809ce0322c0, topicName=留置)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=532e26580241, createdName=xuyong532, createdTime=Thu Apr 25 10:36:00 CST 2019, time=2019-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1697788, encodeId=8c05169e788f2, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Thu Jul 25 08:36:00 CST 2019, time=2019-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1540651, encodeId=239a1540651ef, content=<a href='/topic/show?id=6019e03279f' target=_blank style='color:#2F92EE;'>#留置针#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70327, encryptionId=6019e03279f, topicName=留置针)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cafc13278755, createdName=chshh81, createdTime=Wed Oct 31 08:36:00 CST 2018, time=2018-10-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=350984, encodeId=504435098482, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Tue Oct 30 20:57:05 CST 2018, time=2018-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=350875, encodeId=e31c3508e5bb, content=学习了，涨知识了！, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=王秀, createdTime=Mon Oct 29 19:16:20 CST 2018, time=2018-10-29, status=1, ipAttribution=)]
    2018-10-30 医者仁心5538

    学习了

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=966226, encodeId=40ee966226b3, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d9ee5380218, createdName=ms5000001455536924, createdTime=Mon May 17 11:22:00 CST 2021, time=2021-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1670097, encodeId=bbb416e0097fa, content=<a href='/topic/show?id=809ce0322c0' target=_blank style='color:#2F92EE;'>#留置#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70322, encryptionId=809ce0322c0, topicName=留置)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=532e26580241, createdName=xuyong532, createdTime=Thu Apr 25 10:36:00 CST 2019, time=2019-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1697788, encodeId=8c05169e788f2, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Thu Jul 25 08:36:00 CST 2019, time=2019-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1540651, encodeId=239a1540651ef, content=<a href='/topic/show?id=6019e03279f' target=_blank style='color:#2F92EE;'>#留置针#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70327, encryptionId=6019e03279f, topicName=留置针)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cafc13278755, createdName=chshh81, createdTime=Wed Oct 31 08:36:00 CST 2018, time=2018-10-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=350984, encodeId=504435098482, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Tue Oct 30 20:57:05 CST 2018, time=2018-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=350875, encodeId=e31c3508e5bb, content=学习了，涨知识了！, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=王秀, createdTime=Mon Oct 29 19:16:20 CST 2018, time=2018-10-29, status=1, ipAttribution=)]
    2018-10-29 王秀

    学习了，涨知识了！

    0