提升造血幹細胞移植病人接受護理指導完整率

Project to Promote the Complete Rate of Nursing Education for Patients undergoing Hematopoietic Stem Cell Transplantation

10.3966/168395442016121602005

曾珮菱(Pei-Ling Tseng)；曾鈺雯(Yu-Wen Tseng)；韓晴軒(Ching-Hsuan Han)；陳佳佳(Chia-Chia Chen)；李淑慧(Shu-Hui Lee)

造血幹細胞移植 ； 護理指導 ； 完整率 ； Hematopoietic stem cell transplantation ； nursing education ； completion rate

腫瘤護理雜誌

16卷2期（2016 / 12 / 01）

45 - 58

繁體中文

本專案目的在提升造血幹細胞移植病人接受護理指導之完整率。造血幹細胞移植是治癒許多重大血液疾病（如：白血病、淋巴瘤、再生不良性貧血等）的重要治療措施，而造血幹細胞移植的風險及複雜度高，病人及家屬須投入更多心力配合治療，並學習自我照顧。若於治療實施前有完整的護理指導，將有助於增進病人及家屬對造血幹細胞移植的認知，降低焦慮並提升自我照顧能力。臨床照護中發現，此類病人未能得到整體護理指導之原因包括：造血幹細胞移植病人，對自我照護內容缺乏充分瞭解、護理人員對造血幹細胞移植認知不足、護理指導手冊內容不符合臨床需求等，因此引發改善之動機。改善方案有：一、建立造血幹細胞移植護理指導標準作業程序；二、製作造血幹細胞移植病人護理指導隨身護照；三、舉辦造血幹細胞移植照護在職教育訓練。結果顯示造血幹細胞移植病人接受護理指導完整率由50.8%提升至97.1%。透過建立護理指導標準作業程序，運用護理指導隨身護照及舉辦在職教育，可有效提升造血幹細胞移植病人接受護理指導之完整率。

Hematopoietic stem cell transplantation (HSCT) is a major treatment for hematologic diseases such as leukemia, lymphoma and aplastic anemia. HSCT comes with high risks and complexity, which require intense cooperation and self-care skills from patient and family. Pretreatment nursing education can improve cognition, anxiety, and promote self-care ability. The purpose of the project was to improve the completion rate of nursing education in patients undergoing hematopoietic stem cell transplantation. Before this project, there was insufficient understanding of self-care in patients and insufficient knowledge of hematopoietic stem cell transplantation in nursing staffs; the education manual was inappropriate and nursing continuing education was incomplete. With analysis data of the current procedures, the proposed improvement project included: (1) building a standard operating procedure of nursing care for hematopoietic stem cell transplantation; (2) creating a self-care pamphlet of hematopoietic stem cell transplantation; and (3) arranging nursing continuing education for hematopoietic stem cell transplantation. At the end of the improvement project, the completion rate of nursing education increased from 50.8% to 97.1%. The project entailed constructing standard operating procedure of nursing care, utilizing a self-care pamphlet, and arranging nursing continuing education, all of which contributed to the improvement of completion rate of nursing education for hematopoietic stem cell transplantation.

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