運用多元策略提升外籍照服員胸腔扣擊之正確率

Using Multiple Strategies to Improve the Accuracy Rate of Chest Percussion of Foreign Caregivers

曹雅雯(Ya-Wen Tsao)；林姿秀(Tzu-Hsiu Lin)；王識雅(Shia-Ya Wang)；呂佳蓉(Chia-Jung Lu)；賴美娟(Mei-Chuan Lai)；劉淑倩(Shu-Chien Liu)

外籍照服員 ； 胸腔扣擊 ； 多元策略 ； chest percussion ； foreign caregivers ； multiple strategies

志為護理-慈濟護理雜誌

21卷6期（2022 / 12 / 01）

87 - 97

繁體中文;英文

臨床中外籍照服員來自不同國家，護理人員教導胸腔扣擊技巧時，因語言的隔閡，使其不能完全了解扣擊目的及方法，致胸腔扣擊照護技巧出現問題，間接影響肺部復原，引發動機。原因為：中文衛教單張內容看不懂且圖片不清、溝通困難、缺乏回覆示教輔助工具、外籍照服員胸腔扣擊查核機制及指導之標準流程。專案進行期間：2019年5月至2019年10月，經專案改善（一）舉辦胸腔扣擊護理指導課程。（二）訂定胸腔扣擊指導標準流程。（三）製作「肺部扣擊拍痰與姿勢引流照護技巧輕鬆學_中印語版」圖卡。（四）製作及拍攝「外籍照服員胸腔扣擊_印語版」教學影片。經改善後，外籍照服員胸腔扣擊照護認知正確率由41.2%提升至85.7%，技能正確率35.6%提升至83.1%。

In clinical practice, due to foreign caregivers coming from different countries, when nursing staff teach the chest percussion skills to foreign caregivers, language barriers prevent them from fully understand the purpose and method. This leads to problems in patient's chest percussion care skills and indirectly affects the recovery of the lungs. Reasons that contribute to this issue are: the content of the Chinese health education leaflet is unreadable; the pictures are unclear; general difficulty in communication; lacks of teaching aids and standard procedures for checking and guiding the chest claw skill of foreign caregivers. An improvement project started from May 2019 to Oct 2019, used a strategy that included (I) Holding a course of chest percussion nursing instruction (II) Establishing a standard procedure for thoracic percussions (III) Creating a picture card of "Lung Spur Sputum Shooting and Postural Drainage Care Skills-Easy to Learn_Chinese and Indian Version " (IV) Production and filming of the instructional video of "Chest percussion for foreign caregivers" in Hindi Version". After these interventions, the accuracy rate of foreign caregivers' recognition in thoracic percussion care increased from 41.2% to 85.7%, and the accuracy rate of skills increased from 35.6% to 83.1%.

1. 李有容,鄭杏茹(2018)。運或機會：我國外籍家庭看護工轉換雇主實證分析。調查研究方法與應用，39，123-167。
   連結：
2. 林淞坊,葉敏如,楊芷淇,王郁婷,莊情惠(2019)。運用翻轉教室提升外籍照顧員執行留置導尿管照護正確率。長庚護理，30(3)，333-345。
   連結：
3. 張芝維,鍾靜文,王思涵(2017)。運用翻轉教學提升護理人員執行心導管檢查照護完整率。彰化護理，24(4)，23-3。
   連結：
4. Heng, J. L.,Fan, E.,Chan, E.Y.(2019).Caregiving experiences, coping strategies and needs of foreign domestic workers caring for older people.Journal of Clinical Nursing,28,458-468.
5. Krein, S. L.,Harrod, M.,Collier, S.,Davis, K. K.,Rolle, A. J.,Fowler, K. E.,Mody, L.(2017).A national collaborative approach to reduce catheter-associated urinary tract infections in nursing homes: A qualitative assessment.American Journal of Infection Control,45(12),1342-1348.
6. Simpson, P.(2017).Long-termurethral catheterisation: Guidelines for community nurses.British Journal of Nursing,26(9),22-26.
7. 行政院主計處(2019，4月)．外勞業務統計 ．https://www.dgbas.gov.tw/public/Data/91416410T64W6MTY.pdf
8. 行政院主計處(2019，7月)．國情統計通報(108年6月底老年人口數352萬人，年增5.2％)．https://www.dgbas.gov.tw/public/Data/ 9717160105 LGQ42NT.pdf
9. 林怡孟,王莉晴,陳宜琪,李敏慈,黃淑怡,吳培瑜,杜玉卿(2016)。胸腔物理治療對囊狀纖維化病人痰液排除成效之文獻評讀。華醫學報，45，54-65。
10. 陳美如(2017)。中山醫學大學護理研究所。