完整性臨終護理指導專案

Promotion Completeness of Nursing Instructions of Funeral Preparation in Palliative Care

10.6537/TJHPC.201803_23(1).04

曾麗卿(Li-Ching Tseng)；鄭適芬(Shin-Fen Cheng)；陳昱伃(Li-Yu Chen)；陳依敏(I-Min Chen)

安寧護理人員 ； 臨終準備 ； 護理指導 ； hospice nursing staff ； funeral preparation ； nursing instruction

安寧療護雜誌

23卷1期（2018 / 03 / 01）

46 - 57

繁體中文

研究目的：臨終護理指導的優劣會影響病人善終的品質，經2013年10月到12月發現護理人員在執行臨終指導的完整率僅36.8%，故成立專案小組，旨在提升安寧護理人員執行臨終護理指導的完整性。材料與方法：經分析發現無法完整執行臨終護理指導的主要原因：護理人員對瀕死徵象及臨終護理知識不足、臨終護理指導單張不足、護理指導環境易受干擾、臨終護理指導作業流程規範不明確及護理人員缺乏哀傷溝通技巧。結果：經專案施行，舉辦瀕死徵象及臨終護理在職教育課程、製作臨終護理指導手冊、建置合宜的護理指導地點及標示牌、修訂臨終護理指導流程，並舉辦專題演講及同儕支持團體，使同仁在臨終護理知識的正確率及護理指導完整率皆有所提升。結論：安寧的臨終照護，安寧護理人員不僅需適時警覺病況變化，善用合宜的臨終護理工具，不疾不徐提醒家屬能從容不迫面對家人即將死亡的心理預備，使家屬在經歷喪親的過程中能重新調整悲傷情緒及做好完整的道別。

Purpose: Well preplanning funeral arrangements will affect the good death of the terminal patient. It was noticed that the completeness of funeral nursing instruction was 36.8% in a medical center in Central Taiwan. The objectives of this project were to promote completeness of nursing instructions and to enhance the quality of a good death care. Methods: Root Cause Analysis was used to identified causes of incomplete instructions of funeral preparation. Results: After data analysis, root causes were identified as: (1) insufficient knowledge in funeral custom and heedless of dying signs, (2) lack of standard procedure of funeral preparation, and (3) a shortage of funeral instruction tools. The strategies to resolve these issues included (1) conducting training courses to enhance nursing staff’s education about signs of dying and funeral custom, (2) setting up standardized funeral arrangement instruction procedure, and (3) producing a booklet contains the dying process and funeral preparation. The results showed that knowledge of dying sign and funeral custom had promoted. Conclusion: By sharing this project, it provided important information that hospice nurses must be strongly aware of the deterioration process and provide consistency nursing instructions. It expected that can support families during the death of a loved one will be reached.

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