運用早期目標導向療法於初次入住加護病房敗血症病患之護理經驗

The Nursing Care Experience in Using Early Goal Directed Therapy for Sepsis Patient in ICU

鄭舒方(Shu-Fang Cheng)；簡美芳(Mei-Fang Chien)；何佳璇(Jia-Shiuan He)

早期目標導向療法 ； 敗血症 ； 加護病房 ； Early goal directed therapy ； sepsis ； intensive care unit (ICU)

若瑟醫護雜誌

9卷1期（2015 / 07 / 01）

96 - 106

繁體中文

本文為描述運用早期目標導向於初次入住加護病房敗血症病患之護理經驗，護理期間為2013年5月3至5月25日，經由直接照護、筆談、觀察、身體評估，運用Roy適應、模式進行資料收集與分析，發現病患於住院期間有心輸出量減低、自主換氣障礙、焦慮、等健康問題。照護過程中，筆者運用早期目標導向為基礎提供護理照護，使其維持生理功能且成功脫離呼吸器，並予以關懷、心理支持，鼓勵表達內心成受，主動提供正確資訊與護理指導，讓病患了解疾病過程，以減輕焦慮、戚，協助病患以正向態度面對病情變化，共渡艱辛過程。期望此早期目標導向運用的照護經驗分享，可提供護理人員日後於臨床照護敗血症病患之參考。

This study was described the nursing care experience in using early goal directed therapy for sepsis patient in ICU (intensive care units). The care period was from May 3 to 25, 2013. The author collected information using direct care, conversation by writing, observation, physical examination, and the Roy adaptation model. It was found that patient have decreased cardiac output, impaired spontaneous ventilation, anxiety in the hospital. The author provided the early goal directed therapy as the individual nursing interventions, in order to remove respiratory device and recovery all the physiological functions successfully. In addition to providing concern, psychological support and express feelings, the author providing accurate information and nursing care. Finally, the patient understood the disease process, thus reducing anxiety, and helping the patient with the positive attitude to face the disease. This nursing experience is shared with nurses caring for patients with similar conditions.

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