提高加護病房心臟手術病人術前護理指導完整率專案

Project to Improve the Completion Rate of Preoperative Information for Cardiac Surgery Patient in Intensive Care Unit

10.29494/LN.202203_23(1).0010

邱雅凰(Ya-Huang Chiou)；陳碧君(Bi-Chun Chen)

心臟手術 ； 加護病房 ； 護理指導 ； cardiac surgery ； ICU ； preoperative information

領導護理

23卷1期（2022 / 03 / 01）

115 - 129

繁體中文

由於病人對心臟手術訊息不瞭解，對手術因應能力下降，因此提供適切完整的術前護理指導，給予正確訊息實為重要，故激發此專案改善動機，本專案目的為提高加護病房心臟手術病人術前護理指導完整率。2017年1－2月查檢心臟手術病人護理指導完整率為72%，造成完整率低的主要原因為：缺乏護理指導之在職教育學習、缺乏多元護理指導工具、缺乏稽核制度、無護理指導標準流程及衛教單張閱讀意願不高等。2017年3－7月執行改善措施：舉辦相關在職教育、製作心臟手術前護理指導影片、成立稽核小組並定期稽核、制訂「心臟手術病人術前護理指導」之標準作業流程及修訂相關護理指導單張等。對策實施後護理指導完整率由提升至92.1%，亦降低意外事件的發生率，顯示本專案的具體成效。本專案確實可提高加護病房心臟手術病人術前護理指導完整率，提供病人更佳的照護品質，值得在臨床上繼續推展。

When patients lack understanding of their cardiac surgery, their ability to respond to surgery is reduced. Therefore, it is indeed important to provide appropriate and complete preoperative care guidance as well as precise information. This project is motivated to improve the completion rate of providing preoperative information for cardiac surgery patient in ICU. The completion rate of nursing guidance for cardiac surgery patient was 72% from January to February in 2017. The main reasons for the low completion rate were: lack of in-service education in nursing guidance, lack of multiple nursing guidance tools, and lack of audit systems; no standard procedures for nursing guidance and shallow enthusiasm to read health education leaflets and so on. Implementation of the refine measures initiated from March to July in 2017 include: conduct some relevant in-service education, produce some cardiac surgery preoperative information video, establish a review panel and conduct regular audits, formulate a SOP for ＂preoperative information to cardiac surgery patients＂, and revise the relevant information on patient educational fact sheet. The completion rate of supplying preoperative information has improved from 72% to 92.1% after the implementation of responding measures, reflecting the effectiveness of this project. This project had indeed improves the completion rate by providing preoperative information to cardiac surgery patient in ICU, and hence provide patients with better quality of care. It is worth continuing to be promoted in clinical practice.

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