提升留置導尿管相關膀胱不適護理處置完整率

Improve Intact Rates of Nursing Interventions for Catheter-Related Bladder Discomforts

李彥錚(Yen-Jen Lee)；歐軒如(Shiuan-Ru Ou)；卓知穎(Zhi-Ying Zhuo)；王琬詳(Wan-Hsiang Wang)

留置導尿管 ； 膀胱不適症狀 ； 疼痛 ； bladder discomforts ； catheter ； pain

志為護理-慈濟護理雜誌

17卷4期（2018 / 08 / 01）

91 - 104

繁體中文

留置導尿管相關膀胱不適症狀(CRBD)引起病人自拔導尿管，2013年3-8月間突然3位病人自拔導尿管，造成尿道撕裂傷出血，故引發專案動機。2013年9月9日至10月1日運用CRBD護理處置查檢表，查核CRBD護理處置完整率僅55.6%。導因是沒有從病人的語言評估出CRBD、護理專業知識限制、沒有CRBD護理處置指引及病人主訴不是疼痛，也不知道是CRBD。解決辦法:發展衛教海報及多媒體影片；製作創新CRBD疼痛評估表；發展以實證為基礎的CRBD照顧指引。目的期望CRBD護理處置完整率由55.6%提升至80%。結果CRBD護理處置完整率提升至82.2%，除了緩解CRBD，也沒有自拔留置導尿管狀況，增進護理品質。

Catheter-related bladder discomforts (CRBD) can cause patients to forcibly removed their urethral catheters. From March to August 2013, 3 patients unexpectedly removed their urethral catheters and resulted in urethral laceration. The author was motivated to plan and initiate this project to address the issue. From September 9^(th), 2013 to October 1^(st), 2013, an audit was carried out using CRBD nursing intervention checklist, and as result the completion rate of CRBD nursing intervention was merely 55.6%. The primary causes were the inability to identify CRBD from the patients' complaints, inadequate nursing knowledge, absence of CRBD nursing measure instructions, and that the patients' main complaints were not pain-related and they were unaware of CRBD. Several solutions were introduced, such as producing posters and video clips promoting health education; introducing new CRBD pain assessment form; and developing empirical-based CRBD nursing guidance. The intended goal of project was to increase the completion rate of CRBD nursing interventions from 55.6% to 80%. The actual result was 82.2%, surpassed our intended goal. The project had relieved CRBD, eliminated premature urethral catheter removals, and enhanced nursing quality.

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