比較實施臨床路徑前後之護理品質

Comparison the Quality of Nursing Care between Pre and Post Implementing Clinical Path

10.6974/TCNJ.200206.0077

徐南麗(Nanly Hsu)；賴正芬(Chang-Fen Lai)；謝美玲(Mei-Lin Hsieh)；廖惠娥(Weiao Liao)；林碧珠(Pi-Chu Lin)

臨床路徑 ； 護理品質 ； Clinical path ； Quality of Nursing Care

志為護理-慈濟護理雜誌

1卷2期（2002 / 06 / 01）

77 - 87

繁體中文

本研究在評值未實施臨床路徑及已實施臨床路徑病房三類病人之護理品質，並比較其在四大目標之品質差異。研究方法採類實驗設計，調查時間自88年8月1日起至90年7月31日止，以某醫學中心四個骨科病房為對象。實施臨床路徑前先做前測，實施3個月後做後測，前後測共取296位病人以比較其護理品質。信度採觀察員信度，效度採專家及內容效度。研究結果顯示(1)實施臨床路徑前後在四大目標如目標一「擬定護理計劃」的護理品質平均分數為92.88，91.98；目標二「確保病人生理需要」為90.04，90.15；目標三「確保病人心理、社會、文化及靈性需要」為88.87，87.53；目標四「執行護理目標的評值」為84.30，85.23。(2)二組之間在目標一、二、三、四未有顯著差異。(3)三類病人在四大目標上並無顯著差異。研究貢獻除建立適合評值實施臨床路徑病房之量表外，並已在「四大目標」完成評值實施與未實施臨床路徑病房之護理品質，具體比較其優缺點，以做為教學改進參考。研究結果有助於提升護理品質、減少病人住院天數、節省成本、提升護理人員與病人之滿意度。

This study was to evaluate the quality of nursing care on three types of patients, and compares the quality of nursing care with four objectives, before and after implementing clinical path. This was a quasi-experimental design. The research lasted from Aug. 1, 1999 till July. 31, 2001. Four medical center orthopedics units were used in the sampling. A pre-test and post-test (after 3 months) was conducted. A total of 296 patients were given the pre-test and the post -test. The reliability were counted on inter-rater reliability. Validity were based on exerts' opinions and content validity. The result showed: (1) the quality of nursing care on pre and post-clinical path on four objectives. The mean scores for Objective Ⅰ 「formulating a nursing care plan 」 were 92.88， 91.98; for Objective Ⅱ 「attending patients' physical needs」 the scores were 90.04, and 90.15; for Objective Ⅲ 「attending patients' psycho-social-culture-spiritual need」 the scores were 88.87 and 87.53; for Objective Ⅳ 「the achievement of objectives」 the scores were 84.30 and 85.23. (2) There were no significant difference in the quality of nursing care between pre and post clinical path implementation. (3) There was no significant difference among three types of patients with four objectives. These results helped nurses not only promote the quality of nursing care and decrease the length of stay, but also save money, and increase the satisfaction of both nurses and the patients.