提升經肝動脈灌注化療護理指導完整率

Improve the Completion Rate of the Nursing Care Instructions for Hepatic Arterial Infusion Chemotherapy

陳怡燐(Yi-Lin Chen)；陳翊珺(I-Chun Chen)；吳怡蓁(Yi-Chen Wu)；吳佩盈(Pei-Ying Wu)；吳湘芝(Hsiang-Chih Wu)；吳靜怡(Ching-Yi Wu)；陳育臨(Yu-Lin Chen)；曾維莉(Wei-Li Tseng)

護理指導 ； 經肝動脈灌注化療 ； nursing care instructions ； hepatic arterial infusion chemotherapy

嘉基護理

19卷1期（2019 / 06 / 01）

27 - 39

繁體中文

經肝動脈灌注化療護理指導不完整，可能會發生導管外移，造成化學藥物外滲的危險，進而影響住院天數，對醫療服務品質造成負面影響。經調查護理指導完整率低的原因：護理指導教育訓練不足；護理人員未掌握衛教指導時機、指導內容未統一；未設立查檢表；衛教指導工具缺乏多元性；無稽核制度。改善策略：舉辦在職教育訓練、統一護理指導內容及衛教時機、制訂護理指導查檢表、製作圖解衛教指導書、製作娃娃衛教盒、製作多媒體衛教影片、制定護理指導稽核制度。專案推行後結果發現：護理指導完整率由35.45%提升至100%，導管外移事件0件，肝癌病人照護滿意度由75%提升到95.64%，顯示專案介入措施確有成效，對護理品質具正面之肯定。

The incompleteness of nursing care instructions for hepatic arterial infusion chemotherapy (HAIC) may result in outward catheter migration, which may cause the risk of the extravasation of chemicals and affect the number of days of the hospital stay, leading to negative impacts on the quality of medical services. The reasons behind the low completion rate of the nursing care instructions include: a lack of educational training on nursing care instructions, a lack of prompt health education performed by the nursing staff and a lack of unified instructions; the checklist was not established; the health education instruction tools lacked diversity; and a lack of audit systems. The improvement strategies include: organizing on-the-job educational trainings; unifying the nursing care instructions and providing time for health education; establishing a checklist for the nursing care instructions; creating health education instructional books with graphical explanations; creating manikin kits for health education purposes; creating multimedia videos for health education; and developing an audit system for nursing care instructions. The results revealed that the completion rate of the nursing care instructions increased from 35.45% to 100% with zero cases of outward catheter migration, and the satisfaction rate of patients with liver cancer increased from 75% to 95.64% after implementing the programs, which indicated that the intervention measures were effective and led to positive impacts on the quality of nursing care.

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