運用多元策略提升護理人員化療副作用評估正確率

Using Multiple Strategies to Improve Nursing Accuracy Rate of the Chemotherapy Assessment

10.6880/TJON.202406_24(1).03

林翔宇(Hsiang-Yu Lin)；賴麗君(Li-Chun Lai)；謝雅玲(Ya-Ling Hsieh)；鄭淑雯(Shu-Wen Cheng)

化學治療 ； 副作用 ； 評估 ； 護理人員 ； chemotherapy ； side effect ； assessments ； nurses

腫瘤護理雜誌

24卷1期（2024 / 06 / 01）

29 - 41

繁體中文;英文

化學治療（化療）為癌症病人常見的治療方式。護理師若具備評估化療副作用之能力，將能減少病人副作用惡化及提升介入處理效率。筆者因發現病人實際化療副作用與臨床護理師評估結果不相符，故而引發專案動機。現況分析顯示無完善教學計畫、教育訓練不足、作業標準不完善及評估系統介面不友善等因素導致護理師執行化療副作用評估正確率僅35%。專案小組擬定解決方案包含設置化療副作用評估方式指引、優化化療副作用評估系統介面、推行化療副作用評估教學影片及翻轉教學課程、規劃化療副作用評估臨床技能測驗及修訂「化療副作用評估」學習評核標準。專案經多元化策略實施後，護理師執行化療副作用評估正確率由35%提升至91%，認知測驗平均分數也由85.8分進步至93分，顯示專案措施可有效提升護理師執行化療副作用評估正確率，進而維護癌症病人於化療期間之安全。

Chemotherapy is a common treatment for cancer patients, but treatment may be thwarted due to frequent side effects. Nurses with adequate training to assess chemotherapy side effects can reduce adverse events and enhance intervention efficiency. We find that the incidence of chemotherapy adverse events did not match clinical nurses' assessments of incidence of side effects, which motivated this inquiry study. Current analysis indicates discrepancy resulted from factors such as lack of a comprehensive teaching plan, insufficient educational training, incomplete operating standards, and an unfriendly assessment system interface. These factors lead to nurses' low accurate assessment rate of chemotherapy side effects of only 35%. The project team proposed solutions including establishing guidelines for chemotherapy side effects assessment methods, optimizing the interface of the chemotherapy side effects assessment system, implementing educational videos and flipped classroom courses on chemotherapy side effects assessment, planning clinical skills tests for chemotherapy side effects assessment, and revising the learning assessment standards for "chemotherapy side effects assessment." After implementing diversified strategies, the accuracy of nurses' chemotherapy side effects assessment increased from 35% to 91%, and the average score of cognitive tests also improved from 85.8 points to 93 points. This demonstrates that the project measures can effectively enhance the correct rate of nurses' chemotherapy side effects assessment, thereby ensuring the safety of cancer patients during chemotherapy and continue appropriate treatment.