外科重症生命末期整合護理照護模式

A Care Model: End of Life in Surgical Intensive Care

10.6530/YYN/2015.5.10

許瀚仁(Han-Jen Hsu)；李怡濃(Yi-Nung Lee)；康豑云(Chin-Yun Kang)；陳蕙茹(Hui-Ju Chen)；葉春長(Chun-Chang Yen)；洪東源(Dueng-Yuan Hueng)；高玉玲(Yu-Ling Kao)

生命末期 ； 撤除維生 ； 重症安寧 ； 外科加護病房 ； end of life ； withdrawal of life support systems ； palliative care in intensive care units ； surgical intensive care

源遠護理

9卷3期（2015 / 09 / 01）

20 - 26

繁體中文

外科加護病房特性為緊急與病程變化快速，醫療代理人擔任短期決定重大手術與高科技維生醫療之關鍵角色。自102年1月9日總統已經公布撤除維生醫療合法化，重症末期病人可以尊嚴去世與善終。重症護理師們運用出重症生命末期整合護理照護模式-ABCD，主要護理工作為主動評估、凝聚團隊、陪伴家屬、引導善終等4步驟，擔任如穿針引線的重要溝通角色，遊走在醫療團隊與家屬之間，漸漸凝聚共識後，已成功撤除維生醫療達30個案例，另外有13個案願意器官捐贈。目前我們團隊正積極培養靈性陪伴能力之外也在擬定無心跳器官捐贈流程，期望能一同智慧面對死亡，也可以感受到擁抱生命的力量。

Surgical Intensive Care Unit (SICU) is known for urgent and rapid change of a patient’s medical condition. SICU staff plays a critical role in making decisions in a very limited time regarding emergent surgeries and the use of high-tech medical technology. On January 9, 2013, the President of Taiwan, Republic of China, announced legalization of withdrawing life support for hospice and terminally-ill patients to respect patients’ choice to end their life with dignity. Therefore, intensive care nurses may apply the integrated nursing care model, ABCD, for the successful removal of life support and the end of life care. Nurses role in the four steps of ABCD are Alert, Be patient, Company, and Dying for peace. ICU nurses also facilitate communication between the medical team and the patients’ families. The SICU has successfully withdrawn the life support system in 30 imminent cases with 13 voluntary organ donations. The SICU team is actively cultivating spiritual companionship and developing a standardized protocol for organ donation. The goals are to make patients feel the embrace of life and to face death with wisdom.

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