中部某區域醫院身心科病人嗆咳改善方案

A Project of Improving Psychiatric Patients' Chocking Coughs in a Regional Hospital

10.6847/TJPMHN.202006_15(1).01

王誱竩(Chieh-Yi Wang)；趙蕙方(Huei-Fang Jhao)；姜喬慧(Ciao-Huei Jiang)；林君黛(Jun-Dai Lin)

身心科病人 ； 嗆咳 ； psychiatric patients ； choking coughs

精神衛生護理雜誌

15卷1期（2020 / 06 / 01）

6 - 18

繁體中文

本院身心科於2016年1月至4月住院病人發生嗆咳行為共有483人，佔總住院人數10.34%，平均每日發生高達4次嗆咳行為。分析病人嗆咳原因主要為：未將嗆咳行為納入常規評估項目、對嗆咳行為評估與指導認知不足、缺乏嗆咳行為評估之教育訓練及照護標準不一等。故規劃嗆咳行為評估及指導訓練課程、擬定身心科病人嗆咳改善作業標準流程、身心科病人嗆咳評估表單及監測身心科病人嗆咳行為發生率。結果：身心科護理人員對身心科病人嗆咳評估認知正確率由66.7%提升為86.2%、護理人員確實執行身心科病人嗆咳評估作業標準流程及評估表單執行率達100%、身心科病人嗆咳發生率由10.3%降低為2.9%；故建議重視身心科病人嗆咳行為評估及指導，以提升身心科病人之照護品質。

From January to April in 2016, there were 483 inpatients, approximately equivalent to 10.34% of the total inpatients of the mental health department in the hospital, who have experienced chocking coughs at an average of four times per day. According to our observation, the causes of resulting in patients' chocking coughs could be summarized as follows: the failure to include coughing persistence into routine evaluation items of nursing care, insufficient knowledge about the assessment of coughing events, lack of relevant education training for assessment of choking incidence, and inconsistent standards of nursing care. Therefore, the guidance and training courses of how to assess coughing incidence were later planned, next, the standard operating procedure (SOP) to improve coughing frequency for the patients in the mental department was constructed, and finally, the evaluation forms were designed to record the patients' coughing incidence in the mental health department. The results showed that the accuracy rate for the nurses in the mental health department to assess the patients' coughing incidence increased from 66.7% to 86.2%, the execution rate in actual assessment of mental patients' coughing incidence after following the SOP and the evaluation form requirements reached 100%, and the incidence of choking coughs among mental patients decreased from 10.3% to 2.9%. Thus, it is suggested that when choking coughs persist among mental patients, such incidence should be assessed properly and well guided for a better quality of providing nursing care in the hospital.

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