照顧一位高齡髖部骨折病人之護理經驗

The Nursery Experience of an Elderly Patient with a Hip Fracture

10.6692/KJN.201812_35(3).0009

邱怡儒(Yi-Ju Chiu)；劉倩如(Chien-Ju Liu)；謝生蘭(Sheng-Lan Hsieh)；余月里(Yueh-Li Yu)

髖部骨折 ； 高齡 ； 跌倒 ； 照顧者負荷 ； Hip fracture ； elderly ； falling down ； burden of caregiver

高雄護理雜誌

35卷3期（2018 / 12 / 01）

96 - 106

繁體中文

本文探討一位高齡87歲女性，因跌倒導致髖部骨折而接受左側股骨開放性內固定復位手術後照護經驗。照護期間自2016年4月26日至2016年5月5日，運用Gordon十一項健康功能型態評估，以觀察、會談、傾聽及查閱病歷等方式收集，確立有身體活動功能障礙、潛在危險性跌倒、家庭因應能力增進的準備度等健康問題。照護過程中，以傾聽、主動關懷，與個案及家屬建立良好互動，提供個別及持續性護理措施，透過復健運動，引導日常生活照顧技巧，指導減緩骨質流失方式，預防再次跌倒，整合跨團隊共同照護，瞭解家庭照顧者的困境，入院即提供出院準備服務，強化照顧者照護能力，適時連結長期照護資源，降低照顧者照顧負荷，提升個案及照顧者生活品質。

This article describes the nursing experience of an elderly 87-year-old female patient who had a fall leading to a hip fracture, and then accepted left hip ORIF (open reduction and internal fixation) operation. During the nursing process from April 26, 2016 to May 5, 2016, we applied Gordon's eleven functional health steps to assess the patient's condition and used observations, conversation, listening and referring to the patient's medical records to collect information. The result showed that the patient had problems of physical dysfunction, potential fall hazards, and the ability of coping in family-enhanced readiness. In the nursing process, we used listening, high caring and establishing good interactions with both patient and her family members. We provided individual and persistent nursing intervention along with rehabilitation exercises to guide the skill of daily living, introduce proper diet to increase bone mass, give instruction on how to prevent falls, facilitate integration with the transnational teams' joint care and express understanding of the dilemma of family caregivers. During the period of hospitalization, we provided services to prepare for discharge, intensify caregivers' ability of care, supply related social linking of long-term care resources, reduce caregivers' burden, and enhance the living qualities of the patient and caregivers.