提升護理人員臨終護理指導品質與成效

Enhance the Quality and Effectiveness of the Nursing Education of Dying Phase Preparation

10.6537/TJHPC.201906_23(2).03

吳莉芬(Li-Fen Wu)；施秀鈴(Hsiu-Ling Shih)；張煦婕(Hsu-Chieh Chang)；陳昱光(Yu Guang Chen)；何景良(Ching-liang Ho)；潘雪幸(Hsueh-Hsing Pan)

臨終 ； 護理指導 ； 完整率 ； dying phase ； nursing care ； completion rate

安寧療護雜誌

23卷2期（2019 / 06 / 01）

141 - 154

繁體中文

臨終護理指導在癌末病人照護扮演重要角色，本單位為北部某醫學中心血液腫瘤科病房，2013年1－6月臨終護理指導完整率為90%，第三季驟降至75%、第四季78%，且有兩位家屬投書到院內信箱，質疑護理指導專業性，引發改善動機。分析原因政策面：缺乏宣導、缺乏在職訓練。工具面：單張數量及內容太多、單張內容難瞭解、醫學術語看不懂、字體小缺乏彩色圖示。護理人員面：衛教內容不熟悉、說明缺乏一致性。家屬方面：字體小看得很吃力、單張數量及內容太多。故製作多媒體臨終護理指導影片、製作臨終護理指導QR code、規劃教育訓練等改善方案。專案實施後，護理人員臨終護理指導完整率由75%提升至95%；家屬對臨終護理服務滿意度由57.5%提升至92%，故希望藉此專案後有效提升臨終護理指導完整率，改善照護品質。

Nursing intervention of dying phase for end-of-life care plays an important role in terminal cancer patient. This unit is a hematology oncology ward of a medical center in the north Taiwan. The completion rate of nursing intervention of dying phase was 90% from January to June 2013, and dropped to 75% in the third quarter and 78% in the fourth quarter. In addition, there were two family members who complaints to the hospital mailbox, and questions the professionalism of nursing intervention. These events triggered our motivation to improve. We analyzed the reasons including policies: lack of promotion, and education training; tools: too many sheets and content, difficult to understand the content, incomprehensible medical terms, and small words and lacking color icons; nursing staffs: unfamiliar the education content, and lacking the consistency of explaining the content; family: difficult to see the small words, and too many papers and contents. Therefore, we make the multimedia and QR code for nursing intervention of dying phase, and plan the education training program for nursing staffs. After the implementation of the project, the completion rate of nursing intervention of dying phase was increased from 75% to 95%, and the family satisfaction for nursing care of dying phase was increased from 57.5 % to 92%. We hope this project can enhance the completion rate of nursing intervention of dying phase and improve the quality of nursing care.

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