提升外科加護病房胸腹手術後肺部復健執行率

Enhancing Postoperative Pulmonary Rehabilitation Rates in Patients Undergoing Thoracic or Upper Abdominal Surgery in the Surgical Intensive Care Unit

10.6692/KJN-2017-34-2-3

孫麗君(Li-Chun Sun)；蔡佩卉(Pei-Hui Tsai)；黃家儀(Chia-Yi Huang)；陳淑惠(Ia-Ling Chen)

胸腹部手術 ； 肺部復健執行率 ； 加護病房 ； thoracic and abdominal surgery ； pulmonary rehabilitation implementation rate ； surgical intensive care unit

高雄護理雜誌

34卷2期（2017 / 08 / 01）

28 - 39

繁體中文

胸腹部手術後傷口主要在呼吸肌，易提高肺部合併症的發生率，突顯出術後肺部復健之重要。本單位為外科加護病房使用自訂調查表及認知問卷，統計2012年10至11月，結果顯示本單位胸腹術後病人肺部復健執行率僅37.5%，護理人員對胸腹手術後肺部復健的認知度僅60.5%，且多數未受完整在職教育，發現單位缺乏肺部復健流程、護理指導資料及連續一致性交班等問題，故成立專案小組，加以改善。藉由制訂肺部復健流程、舉辦在職教育、製作護理指導手冊、交班單及指導看板，提升護理人員的認知度進而提高病人執行率。經專案實施後，顯示護理人員胸腹術後肺部復健的認知度提升至91.4%、病人執行率提升至84.4%，顯示專案之成效。筆者希望藉由本專案的推行，強調胸腹手術後病人早期於加護單位執行肺部復健之重要，以提升重症臨床照護品質。

Wounds from thoracic or upper abdominal surgery strongly affect the respiratory muscles. They tend to increase the incidence of pulmonary complications, which highlights the importance of postoperative pulmonary rehabilitation. According to the data collected from October to November 2012 in our surgical intensive care unit, the postoperative rehabilitation implementation rate was only 37.5%, and the nurses' awareness of postoperative pulmonary rehabilitation was only 60.5%. The team was established due to incomplete nurse's education, pulmonary rehabilitation process, nursing guidance materials, and sustained care. By developing pulmonary rehabilitation protocols, organizing in-service education, and preparing a nursing instruction manual, handout forms and guidance signage, nurse's awareness and patient's rehabilitation implementation rate were increased. The results of this project showed that nurses' awareness of postoperative pulmonary rehabilitation increased from 60.5% to 91.4% and the patient's implementation rate increased from 37.5% to 84.4%. The early post-op pulmonary rehabilitation for patients undergoing thoracic or upper abdominal surgery enhanced the quality of nursing care through this project.