提升護理人員對燒燙傷病人復健護理指導執行率

Improving the Completeness Rate of Nursing Staff's Rehabilitation Nursing for Patients with Burns

10.6540/NTJN.202003_22(1).0006

黃素卿(Su-Ching Huang)；陳淑玲(Shu-Ling Chen)；黃素貞(Su-Chen Huang)；張雅惠(Ya-Hui Chang)

燒燙傷 ； 疤痕 ； 攣縮 ； 復健 ； burns ； scar ； contracture ； rehabilitation

新臺北護理期刊

22卷1期（2020 / 03 / 01）

63 - 72

繁體中文

燒燙傷對病人而言，是件毀滅性的人生大事，當病人面臨疤痕增生問題，輕則影響日常精細活動，如握拳、眨眼，重則影響肢體功能。臨床發現，為使護理人員得以提供連續性照護，以正確協助病人執行復健，減少對於病人復健執行內容不清楚或無一致性之問題，故成立專案小組，目的為提升護理人員對燒燙傷病人復健護理指導執行率。藉由制定復健護理指導標準、製作復健衛教手冊、舉辦在職教育、增設復健記錄資訊作業、舉辦燒傷病友復健座談會與復健護理品質監控等措施。經專案實施後護理人員執行復健護理指導執行率由37%提升至95%。冀望持續相關的專案改善能減輕病人不適及提升復健成效，增加其肢體的功能性，進而增進病人自我照護能力、生活品質，以重返家庭及社會。

Burn injury can be a devastating event for a patient. Because of scar formation, a patient's daily activities such as making a fist or blinking can be affected; furthermore, challenges in physical function would also be involved. According to clinical findings, the nursing staff can be unclear and inconsistent with the implementation of patient rehabilitation. In order to provide continuity of care to assist proper patient rehabilitation, a project group was established. Its purpose was to improve the total implementation rate of burns rehabilitation for the nursing staff. The total implementation rate of the nursing staff for providing rehabilitation instruction increased from 37% to 95% after project implementation by adopting the following measures: development of guidance standards for rehabilitation care, production of rehabilitation health education manuals, on-the-job training, increase in rehabilitation execution records, organization of seminars for rehabilitation of burn patients, and quality care monitoring. By the continuous improvement of relevant projects, patients' discomfort can be reduced. The effectiveness of rehabilitation can be enhanced and the functional capacity of the limbs can be increased. Eventually, patients' self-care ability, quality of life, and personal and social interactions would improve.

1. 修慧蘭,董采真,陳柏誠,王家瑋(2016)。燒燙傷患者整合復健之歷程與介入策略。輔導季刊，52(1)，14-23。
   連結：
2. 陳生松(2016)。我是職能治療師，燒傷復健路上我陪你。護理雜誌，63(1)，42-48。
   連結：
3. 羅淑芬(2015)。嚴重燒燙傷病人護理處置。護理雜誌，62(4)，82-88。
   連結：
4. Dahl, O.,Wickman, M.,Wengström, Y.(2012).Adapting to life after burn injury-reflections on care.Journal of Burn Care & Research,33(5),595-605.
5. Friedstat, J. S.,Hultman, C. S.(2014).Hypertrophic burn scar manage-ment: What does the evidence show? Asystematic review of randomized controlled trials.Annals of Plastic Surgery,72(6),198-201.
6. Godleski, M.,Oeffling, A.,Bruflat, A. K.,Craig, E.,Weitzenkamp, D.,Lindberg, G.(2013).Treating burn-associated joint contracture: Results of aninpatient rehabilitation stretching protocol.Journal of Burn Care & Research,30(4),420-426.
7. Serghiou, M.,Cowan, A.,Whitehead, C.(2009).Rehabilitation after a burn injury.Clinics in Plastic Surgery,36(4),675-686.
8. Thananopavarn, P.,Hill, J. J.(2017).Rehabilitation of the Complex Burn Patient with Multiple Injuries or Comorbidities.Clinics in Plastic Surgery,44(4),695-701.
9. 吳佳儀,李明濱,吳其炘(2015)。燒傷之身心問題與全人照護。臺灣醫界，58(8)，9-14。
10. 李映琪,郭怡良(2016)。燒燙傷中心患者的早期物理治療。物理治療，41(4)，254-263。
11. 林佩芬（校閱）(2010).教學原理─在護理實務上之應用.台北市:華杏.
12. 許煌澤(2012).護理品質管理─理論與實務.台北市:華杏.
13. 陳巧旻,林凱慧,蘇綉雅,林梅香,許菊玲(2014)。新生兒加護病房早產兒正確築巢擺位照護模式之改善專案。護理雜誌，61(2附冊)，S41-S49。
14. 衛生福利部統計處（2017，1月10日）‧全民健保統計年報 ‧取自http://www.mohw.gov.tw/cht/DOS/Statistic_P.aspx?f_list_no=312&fod_list_no=6419&doc_no=59364
15. 藍忠孚（校閱）(2012).醫療品質管理學.台北市:華杏.