應用出院準備服務計劃於一位多重併發症早產兒之護理經驗

A Nursing Experience of Applying Discharge Planning on a Premature Baby with Multiple Complications

10.29936/DMFCCHJN.201006.0006

劉鳳珍(Fen-Chen Liu)；謝淑娟(Shu-Chuan Hsieh)；林玉華(Yu-Hua Lin)；周汎澔(Fan-Hao Chou)

多重併發症早產兒 ； 出院準備服務 ； 護理 ； premature baby with multiple complications ； discharge planning ； nursing

嘉基護理

10卷1期（2010 / 06 / 01）

47 - 57

繁體中文

隨著醫學及照護的日益發展，早產兒的存活率雖已可達90%，但因早產而衍生的併發症，使得家有早產兒的父母，在面臨早產兒即將返家之際顯現出困難的處境。本文即是敘述一位極低體重早產兒，因併發多種疾患而導致出院困難，筆者運用出院準備服務計劃，協助其順利出院並回歸家庭之照護經驗。在住院期间，筆者運用出院準備服務模式，收集個案生理資料及理學檢查報告，觀察家人與個案之互動、與個案家人會談，藉以評估個案現存之醫療照護問題、出院困難原因及家庭照護之需求，發現個案有身體活動功能障礙及營養狀況少於身體所需的護理問題，而家庭則有照顧者角色緊張及親子依附關係改變之護理問題。因此予擬定出院準備服務計劃及安排出院準備服務討論會，促使家人參與整個照護過程，重新認識患兒，並指導主要照顧者學習餵食、沐浴、肢體復健運動之照護技巧，告知緊急救護方式和協尋管道，以增加父母在照顧上的信心及能力，使個案得以順利出院返家，並能獲得持續性的照護。

With the advanced development of medical technology and caring skills, the current survival rate of premature babies has reached 90%. A premature birth may result in some complications. Then, parents who have premature babies will appear difficulty situations when they face premature babies with discharging from hospitals. This paper described a nursing experience of applying discharge planning on a premature baby with multiple complications and her family. The data were collected through observations, interviews, systemic physical assessment as well as case discussion meetings during hospitalization. The major health problems of the case included disability of physical activity, nutrition less than body requirements, role strain of caregiver, and change of parent-child attachment. Through the nursing process, the author provided discharge planning and arranged related case conference meetings to facilitate families engaging in caring process. The author also supplied health education of caring skills in daily life such as feeding, bathing, and limb rehabilitation as well as information related urgent care strategies and resources to the primary caregiver. It improves parents' confidence and ability of care. The case, then, could he discharged successfully and have sustained holistic care after discharge.