Term bebeklerde topuk kanı alınmasında manuel lanset ile otomatik lansetin ağrı düzeyine etkisinin incelenmesi
Küçük Resim Yok
Tarih
2015
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Term Bebeklerde Topuk Kanı Alınmasında Manuel Lanset ile Otomatik Lansetin Ağrı Düzeyine Etkisinin İncelenmesi Amaç: Bu araştırma term bebeklerde topuk kanı alınmasında manuel lanset ile otomatik lansetin ağrı düzeyine etkisini incelemek amacıyla yürütülmüştür. Yöntem: Araştırma kesitsel, analitik, deneysel bir çalışmadır. Araştırmaya ?37 gebelik haftasında doğmuş olan 60 term bebek alınmıştır. Topuk kanı alma işlemi tek günlerde manuel lanset ile, çift günlerde otomatik lanset ile gerçekleştirilmiştir. Tüm bebeklerde ponksiyon sol topuğun lateralinden yapılmıştır. Nabız sayısı ve oksijen saturasyonu pulse oksimetre ile ölçülmüştür. Tüm topuk kanı alma işlemleri video kamera ile kayıt edilmiştir. Bebeklerin ağrı düzeyi iki uzman hemşire tarafından videolar izlenerek NIPS(Neonatal Infant Pain Score) ile değerlendirilmiştir. Ayrıca bu çalışmada topuğa uygulanan ponksiyon sayısı, kanın tüpe alınma süresi, bebeklerin ağlama durumu, test tekrar gerekliliği, kan bilirübin düzeyi, kan hematokrit değeri ve işlemden 4 saat sonraki topukta meydana gelebilecek komplikasyonlar (ısı artışı, sertlik, ödem, kızarıklık, morarma) değerlendirilmiştir. Verilerin analizinde Wilcoxon Testi, Ki-Kare Testi, Mann-Whitney U testi ve T-Testi uygulanmıştır. Bulgular: İşlem sonrası ortalama oksijen saturasyonu manuel lanset grubunda, otomatik lanset grubuna göre anlamlı derecede düşük olarak saptanmıştır (P<0.001). Ortalama nabız sayısı manuel lanset grubunda işlem sonrası, otomatik lanset grubuna göre anlamlı olarak yüksek saptanmıştır (P<0.05). Ağlayan bebek yüzdesi otomatik lanset grubunda manuel lanset grubuna göre anlamlı derecede düşüktür (P<0.001). Manuel lanset grubunda yeterli miktarda kan alabilmek için gerekli olan ponksiyon sayısı anlamlı derecede fazladır (P<0.001). Ortalama kanın tüpe alınma süresi otomatik lanset grubunda anlamlı düzeyde kısadır (P<0.001). İşlem sonrası komplikasyonlardan ısı artışı, sertlik ve ödem açısından iki grup arasında fark saptanmazken otomatik lanset grubunda kızarıklık (P<0.05), morarma (P<0.001) daha az izlenmiştir. Otomatik lanset grubunda NIPS ortalaması manuel lanset grubuna göre anlamlı derecede düşükür (P<0.001). Alınan kanlardan çalışılan kan hematokrit değeri otomatik lanset grubunda düşük iken (P<0.001), kan bilirübin düzeyi her iki grup arasında farklılaşmamıştır (P>0.05). Sonuç: Topuk kanı alma işleminde otomatik lanset kullanımı ağrı düzeyini, komplikasyon gelişimini, ponksiyon sayısını, kanın tüpe alınma süresini azaltmakta ve yenidoğanın işlem sırasındaki konforunu arttırmaktadır. Anahtar Kelimeler: yenidoğan; ağrı; lanset; topuk kanı
Effect of Automatic Lancet and Manual Lancet for Heel Blood Sampling on Level of Pain at Term Infants Aim: The objective of this study is to evaluate the effect of automatic and manual lancet for heel blood sampling on pain level. Method: This research is a sectional, analytic and experimental study. Sixty healthy full-term neonates with a gestational age of 37 weeks or more were enrolled in this study. To randomize the subjects manual lancet was used at odd days and automatic lancet was used at even days for heel blood sampling. Lateral side of left heel was chosen for sampling at all infants. All heel blood sampling procedures were recorded by video camera. Heart rate and oxygen saturation were measured by pulse oximeter. To assess the pain level of infants, two expert nurses calculated NIPS scores (Neonatal Infant Pain Scale) by watching videos. Also puncture number, time to collect adequate blood volume, crying status, necessity of repeating procedure, complications that can occur after 4 hours from procedure(increased heat, swelling, redness, edema and bruise),blood bilirubin and hematocrit levels were evaluated. Wilcoxon test, Chi-square test, Mann-Whitney U test and T-test were used for analysis of data. Results: Post procedure mean oxygen saturation was significantly lower (P<0.001) and post procedure heart rate was significantly higher (P<0.05) in manual lancet group according to automatic lancet group. Rate of crying infants was lower at automatic lancet group (P<0.001). Number of punctures to obtain adequate blood volume were significantly higher at manual lancet group (P<0.001). Mean blood collection time was significantly shorter at automatic lancet group than manual lancet group (P<0.001). Among the post procedural complications there was no significant difference between two groups in swelling, edema and increased heat, but redness (P<0.05) and bruise (P<0.001) were lower at automatic lancet group. Mean of NIPS scores was significantly lower at automatic lancet group (P<0.001). While bilirubin levels did not show significant difference between two groups (P>0.05), hematocrit levels are lower at automatic lancet group (P<0.001). Conclusion: Our study demonstrated that automatic lancet use for heel blood sampling decreases pain level, complication rate, number of puncture, blood collection time and increases infant's comfort during the procedure. Keywords: infant; pain; lancet; heel blood sampling
Effect of Automatic Lancet and Manual Lancet for Heel Blood Sampling on Level of Pain at Term Infants Aim: The objective of this study is to evaluate the effect of automatic and manual lancet for heel blood sampling on pain level. Method: This research is a sectional, analytic and experimental study. Sixty healthy full-term neonates with a gestational age of 37 weeks or more were enrolled in this study. To randomize the subjects manual lancet was used at odd days and automatic lancet was used at even days for heel blood sampling. Lateral side of left heel was chosen for sampling at all infants. All heel blood sampling procedures were recorded by video camera. Heart rate and oxygen saturation were measured by pulse oximeter. To assess the pain level of infants, two expert nurses calculated NIPS scores (Neonatal Infant Pain Scale) by watching videos. Also puncture number, time to collect adequate blood volume, crying status, necessity of repeating procedure, complications that can occur after 4 hours from procedure(increased heat, swelling, redness, edema and bruise),blood bilirubin and hematocrit levels were evaluated. Wilcoxon test, Chi-square test, Mann-Whitney U test and T-test were used for analysis of data. Results: Post procedure mean oxygen saturation was significantly lower (P<0.001) and post procedure heart rate was significantly higher (P<0.05) in manual lancet group according to automatic lancet group. Rate of crying infants was lower at automatic lancet group (P<0.001). Number of punctures to obtain adequate blood volume were significantly higher at manual lancet group (P<0.001). Mean blood collection time was significantly shorter at automatic lancet group than manual lancet group (P<0.001). Among the post procedural complications there was no significant difference between two groups in swelling, edema and increased heat, but redness (P<0.05) and bruise (P<0.001) were lower at automatic lancet group. Mean of NIPS scores was significantly lower at automatic lancet group (P<0.001). While bilirubin levels did not show significant difference between two groups (P>0.05), hematocrit levels are lower at automatic lancet group (P<0.001). Conclusion: Our study demonstrated that automatic lancet use for heel blood sampling decreases pain level, complication rate, number of puncture, blood collection time and increases infant's comfort during the procedure. Keywords: infant; pain; lancet; heel blood sampling
Açıklama
Anahtar Kelimeler
Hemşirelik, Nursing
