台灣居家傷口照護挑戰與展望：高齡社會下的策略思考

Challenges and Prospects of Home Wound Care in Taiwan: Strategic Reflections in an Aging Society

林筱青(Hsiao-Ching Lin)；陳桂敏(Kuei-Min Chen)；李碧娥(Bih-O Lee)；吳佳芬(Chia-Fen Wu)；游靜怡(Ching-Yi Yu)；王秀紅(Hsiu-Hung Wang)

居家傷口照護 ； 政策挑戰 ； 超高齡社會 ； Home Wound Care ； Policy Challenges ； Aged Society

嘉基護理

24卷1期（2024 / 06 / 01）

34 - 42

繁體中文;英文

本文深入探討台灣居家傷口照護的現況與面臨的政策挑戰，同時提出未來發展的建議。隨著2027年超高齡社會的到來，意味著未來將有越來越多需要居家照護的高齡、獨居或缺乏照顧者的個案，一旦產生壓力性損傷、糖尿病潰瘍、下肢動脈性潰瘍和下肢靜脈性潰瘍等慢性傷口，個案除了要面臨身體功能退化、衰弱或失能的風險，以及認知日趨退化，若還要學會傷口照顧技能，將會面臨傷口照護的困境。然而，居家傷口照護領域面臨多重的挑戰，包括：護理人力不足、健保給付不足、訪視頻率不足、傷口照護培訓不完整以及缺乏傷口團隊的支援等，特別對多處慢性傷口的個案而言更加嚴峻。面對這些挑戰，呼籲政府更關注居家護理師的專業性，並提供相應的支援，重新評估報酬標準。同時建議建立居家傷口照護的遠距醫療系統，提供即時專業的意見。針對培訓方面，建議重新檢視居家傷口照護課程的內容，建立系統性培訓認證課程，以提升居家護理師的專業素養。期盼政府能持續解決居家傷口照護的挑戰，確保其能更好地滿足社會需求。

This paper delves into the current status and policy challenges of home wound care in Taiwan, presenting recommendations for future development. With the arrival of the hyper-aged society in 2027, there will be an increasing number of elderly individuals, those living alone, or those lacking caregivers who will require home care. Once they generate chronic wounds such as pressure injuries, diabetic ulcers, arterial ulcers, or venous ulcers, these individuals not only face the risk of physical function deterioration, weakness, or disability but also encounter challenges due to cognitive decline. Learning wound care skills becomes an additional hurdle. However, the field of home wound care confronts several challenges, including a shortage of nursing manpower, inadequate health insurance coverage, infrequent home visits, insufficient training in wound care, and lack of support from wound team particularly for cases with multiple chronic wounds. In response to these challenges, there is a call for increased government focus on the professionalism of home care nurses, along with corresponding support and a reassessment of compensation standards. Additionally, the suggestion is to establish a telemedicine system for home wound care, providing real-time professional advice. In terms of training, it is recommended to review the content of home wound care courses and establish systematic training certification programs to enhance the professional competence of home care nurses. The hope is that the government will consistently address the challenges of home wound care, ensuring its capacity to better meet societal needs.