運用ADDIE教學模式提升新進護理人員腸造口照護完整率

Improving Colostomy Care Training for Novice Nurses with ADDIE Instructional Model

10.6880/TJON.201903/SP_19.14

柯幸芳(Hsing-Fang Ko)；吳淑芬(Shu-fen Wu)；蔣玉滿(Yu-Man Chiang)；郭美玲(Mei-Ling Kuo)

新進護理人員 ； 腸造口 ； 滿意度 ； the novice nurse ； colostomy care ； satisfaction

腫瘤護理雜誌

19卷增訂刊（2019 / 03 / 01）

169 - 182

繁體中文

背景：腸造口照護技能不純熟，導致增加新進護理人員挫折感，病患及家屬的不信任，因此引發專案小組改善動機，調查發現新進護理人員腸造口照護完整率為29.34%，護理指導滿意度為58.6%。目的：本專案旨在提升新進護理人員對腸造口照護完整率達91%以上及腸造口照護護理指導滿意度達85%以上。解決方案：經文獻查證及團隊討論後以ADDIE教學模式設計相關改善策略，包括（1）籌畫腸造口照護在職教育課程；（2）模型輔助學習；（3）心智圖操作；（4）腸造口教學DVD；（5）跨領域醫療聯合討論會；（6）腸造口情境式影片及測試等。結果：新進護理人員對腸造口照護完整率從29.34%提升至93.48%，新進護理人員腸造口照護護理指導滿意度由改善前58.6%提升至94.2%。結論：期望藉此專案分享運用ADDIE教學模式，提升新進護理人員腸造口照護完整率，以提升臨床護理照護品質。

Background: Inadequate care-giving skills of colostomy care result in distrust of patients and their family members in the novice nurses which contributes frustration of the nurses. The novice nurse analyses revealed that the completion rate of colostomy care was 29.34% while nursing instruction satisfaction was 58.6%. Purpose: This project was designed to improve the novice nurses' completion rate of colostomy care to reach 91% or higher and nursing instruction satisfaction of colostomy care to 85%. Resolution: Literature review and team discussions were conducted for application of ADDIE instructional model as the improvement plan, including (1) planning of in-service education course of colostomy care: (2) model aided learning: (3) Mind Map operating; (4) Colostomy teaching DVD; (5) Joint Conference on interdisciplinary medicine; and (6) Projects such as situated learning videos and rehearsal tests of colostomy care. Results: The novice nurse completion rate for colostomy care was seen to boost significantly from 29.34% to 93.48%. The novice nurse nursing instruction satisfaction of colostomy care improved from 58.6% to 94.2%. Conclusion: This project effectively enhanced the completion rate of colostomy care of the novice nurses to improve the quality of the clinical nursing care by using the ADDIE instructional model.

1. 黃晴雯, C. U.,郭惠敏, H. M.(2015)。測試多媒體患者教育方案提昇門診患者的高壓氧知識。新臺北護理期刊，17(1)，33-44。
   連結：
2. 劉淑娟, S. J.,陳豐霖, F. L.,楊佰能, B .N.(2016)。兒童心臟手術前護理指導影片對病童母親焦慮與相關知識之影響。長庚護理，27(3)，321-333。
   連結：
3. Allen, J.,Hutchinson, A. M.,Brown, R.,Living-ston, P. M.(2018).User experience and care for older people transitioning from hospital to home: Patients’ and carers’ perspectives.Health Expectations,21(2),518-527.
4. Burch, J.(2010).Looking after stomas and peristo-mal skin.Nursing & Residential Care,12(9),430-436.
5. Gathercole, S. E.,Baddeley, A. D.(2014).Work-ing memory and language processing.New York, NY:Psychology Press.
6. Klemenc-Ketis, Z.,Kersnik, J.(2011).Using movies to teach profess- ionalism to medical students.BMC Medical Education,11(1),60.
7. Molenda, M.(2003).In search of the elusive ADDIE model.Performance Improvement,42(5),34-36.
8. Murphy-Shigematsu, S.(2010).Respect and empa-thy in teaching and learning cultural medicine.Journal of General Intern Medicine,25(2),194-195.
9. Omansky, G. L.(2010).Staff nurses’ experiences as preceptors and men- tors: An integrative review.Journal of Nursing Management,18(6),697-703.
10. Pittman, J.,Bakas, T.,Ellett, M.,Sloan, R.,Rawl, S. M.(2014).Psychometric evaluation of the ostomy complication severity index.Journal of Wound Ostomy & Continence Nursing,41(2),147-157.
11. Yeh, Y. F.,Lin, T. C.,Hsu, Y. S.,Wu, H. K.,Hwang, F. K.(2015).Science teachers’ pro-ficiency levels and patterns of TPACK in a practical context.Journal of Science Educa-tion and Technology,24(1),78-90.
12. 李書芬, S. F.,郭梅珍, M. C(2014)。身體檢查與評估技術影音教學光碟與手冊之製作與應用。耕莘學報，12，5-14。
13. 林貴滿, G. M.(2015)。消化系統疾病病人之護理。內外科護理學上冊，台北=Taipei, Taiwan, ROC:
14. 郭鳳霞, F. X.,葉明理, M. I.,孫吉珍, J. Z.,鄭秀桃, X. T.(2003)。某區域醫院內科病房護理人員鼻胃管灌食技術的教學評估．醫護教育學刊。醫護教育學刊，1，42-47。
15. 曾淑榆, S. Y.,謝雅婷, Y. T.,王晶瑩, J. Y.,林秀如, H. J.,沈永釗, Y. C.,簡麗瑜, L. Y.(2013)。提昇護理人員對術後腸造口照護之完整性．長庚科技學刊。長庚科技學刊，19，137-149。
16. 馮明珠, M. C.,陳幼梅, Y. M.,吳玲琨, L. K.,吳鈴珠, L. C.(2011)。三個月內新進護理人員感受護理臨床工作之壓力與因應經驗。護理暨健康照護研究，7(2)，98-107。
17. 黃素雲, S. Y.,洪慧娟, H. C.,蔡崇煌, C. H.,王素美, S. M.,胡蓮珍, L. J.(2015)。心智圖軟體在醫護教育的應用 Applications of mind map-ping software in health care education。澄清醫護管理雜誌，11(2)，30-38。
18. 羅慧玲, H. L.,江玉玲, Y. L.,詹惠蓉, H. J.,施淑芳, S. F.,陳麗琴, L. C.,李秀蘭, H. L.(2013)。提升護理人員對植髮術後護理指導之改善專案．醫院雙月刊 Enhancing the nursing completence and ability in post-operative instructions for pa-tients after hair transplantation。醫院雙月刊，46(1)，36-51。

1. (2023)。運用ADDIE教學模式提升精神科護理人員儀器操作正確率。精神衛生護理雜誌，18(2)，35-42。
2. (2024)。運用ADDIE教學模式提升手術室NPGY緊急顱內出血術前準備完整率。新臺北護理期刊，26(2)，87-100。