運用擬真科技提升氣切造口病人主要照顧者換藥正確性

Application of Simulating Technology to Enhance Accuracy of Tracheostomy Care for the Main Tracheostomy Patient Caregivers

10.29494/LN.202209_23(3).0012

黃莉綾(Li-Lin Huang)；許嘉玲(Chia-Ling Hsu)；曹書寧(Shu-Ning Tsao)；曾依婷(I-Ting Tseng)；高淑雰(Shu-Fen Kao)；李雅惠(Ya-Hui Lee)

氣切造口 ； 虛擬實境 ； 快速響應矩陣圖碼 ； tracheostomy ； virtual reality ； Quick Response Code

領導護理

23卷3期（2022 / 09 / 01）

166 - 180

繁體中文

氣切可增加呼吸器脫離率，正確執行氣切造口換藥是預防感染最有效的方法，臨床發現指導介入時機不當導致家屬抗拒學習、無法確認主要照顧者或學習倉促，且工具僅文字單張，導致氣切造口換藥正確性僅50.66%、認知45.33分。本專案為期10個月，旨在提升主要照顧者氣切造口換藥正確性。經現況分析發現氣切造口換藥認知不足、指導介入時機不當、缺乏多元指導輔助工具。拍攝互動式虛擬實境（virtual reality，VR）氣切造口換藥影片及QR Code、制訂指導流程、製作模具、換藥圖片單張與口訣。提升主要照顧者換藥正確性達100%、認知為94.44分，達成目標。運用VR體驗、模具練習、影片QR Code及改變實施流程等策略，解決病人主要照顧者困擾，提升照護正確性。

Tracheostomy helps increasing the rate of ventilator detachment, and correct implementation of tracheostomy dressing is the most effective way of preventing wound infection. Clinical discovers that improper timing guidance of intervention leads to the caregiver learning resistance, inadequate identification of the main caregiver or rapid learning. Besides, the instructor tools are merely text leaflet, resulting in only 50.66% of the accuracy for tracheostomy dressing and 45.33 points for cognition. This ten month project aims to improve the accuracy for tracheostomy dressing changes by primary caregivers. Analysis of the current situation found that the awareness of tracheostomy dressing change was deficient, the timing of guidance intervention was inappropriate, and there was lack of multiple guidance and auxiliary tools. The implementations include: shooting an interactive virtual reality (VR) tracheostomy dressing change video and print QR code on the leaflets for link to review the video at home; formulate a guiding process, make a mold, and add an imagery leaflet and introduce formula for dressing change. The goal was achieved as the result of the accuracy regarding dressing change by the primary caregiver went up to 100% in tracheostomy measures and 94.4 points in cognition testing. Establishment of strategies such as VR experience, mold practice, video QR Code and modify the implementation process proved to resolve the problem of the patient's main caregiver and improve the accuracy of care.

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