日本新生児成育医学会雑誌　35(1)：95-103；2023　

日本新生児成育医学会雑誌　第35巻　第1号　95 ～ 103頁（2023年）

受付日：2022．01．17

受理日：2022．09．05

NICU 入院児への看護師による注射・採血実施の実態と看護管理者の認識

The Current Situation and Nursing Managers’ Perceptions of Injection and Blood Sampling by Staff Nurses in the Neonatal Intensive Care Unit

獨協医科大学　看護学部

Dokkyo Medical University, School of Nursing

小西美樹

Miki KONISHI

Key Words：injection，blood sampling，task shifting，nurse manager，neonatal nursing

注射・採血は医師の指示の下で看護師が実施可能な医行為であり，チーム医療推進や医師の業務負担軽減の観点 から看護師へのタスク・シフト／シェア（業務移管や共同化）が期待されている。NICU 看護師の注射・採血実施 の実態把握と実践普及への示唆を得ることを目的に，周産期母子医療センター407 施設の看護師長を対象に無記名 自記式質問紙調査を行い，94 施設から回答を得た。看護師による実施は血糖測定73％，足底採血26％，静脈採血 6％，ルート確保4％，ワンショット54％，筋肉注射2％，皮下注射5％だった。看護師が実施しない主な理由は「医 師の業務として確立している」「処置の難易度が高い」で，「看護師が注射・採血を実施すべき」としたのは18％ だった。依然，本邦のNICU では看護師による注射・採血実践は普及していないことが明らかとなった。専門性の 高い新生児医療の現場で，看護師によるNICU 入院児への注射・採血を安全に普及するための基準や体制構築が望 まれる。

Invasive procedures such as injection and blood sampling are medical procedures that can be performed by nurses under a physician’s direction. It is expected that nurses perform these procedures as task shifting and task sharing to reduce the physicians’ workload from the perspective of promoting a collaborative approach to healthcare. This study was conducted to clarify the actual injection and blood sampling situation and to obtain suggestions for ways to promote the performance of these procedures among the NICU（ neonatal intensive care unit） nurses. To investigate the current situation of NICU nurses’ performance of invasive procedures and their perceptions of those procedures, the nurse managers of 407 perinatal medical centers in Japan were asked to respond to a questionnaire. A total of 94 responses were analyzed. The invasive procedures performed by NICU nurses were blood glucose tests with a glucometer（ 73％）, heel sticks（ 26 ％）, venipuncture（ 6％）, peripheral intravenous line placement（ 4％）, intravenous push medication（ 54％）, subcutaneous injection （5％）, and intramuscular injection （2％）. For the NICU nurses who did not perform invasive procedures, the top two reasons given were “established as a physicians’ task” and “difficulty of the procedure.” Only 18％ of the respondents agreed that NICU nurses should perform injection and blood sampling as nursing procedures. Performance of injection and blood sampling by NICU nurses is still not widespread in Japan. It is believed by most nurse managers that injection and blood sampling are not nurses’ primary roles. Therefore, it is necessary to have discussions among the parties concerned about the implementation of the invasive procedures while ensuring the safety of patients in the highly specialized nursing field.