以病人為中心的照護－論加護中心會客制度

Patient-Centered Care: What's New in ICU Visiting Policies?

10.6530/YYN/2018.5.4

吳國湘(Kuo-Hsiang Wu)；林利珍(Li-Chen Lin)

重症 ； 加護中心 ； 會客限制 ； 以病人為中心 ； intensive care unit ； visiting policy ； patient-centered care

源遠護理

12卷1期（2018 / 03 / 01）

46 - 50

繁體中文

加護中心限制會客的原因，普遍認為為使重症病人充分休息、降低感染機會、及避免家屬對醫療照護干擾而來；但入住加護中心，對重症病人及家屬都是重大的壓力事件，限制會客的規定會加重此一壓力。近期研究發現，家屬的陪伴不僅能減少重症病人及家屬的焦慮程度，亦可減少肺水腫、心律不整等心血管併發症發生率，重症病人的死亡率亦有下降的趨勢。開放會客後，雖然病室內細菌菌落數上升，但病人的感染發生率並未因此上升。大部分的家屬在重症治療過程中亦可扮演支持幫助的角色，而非干擾治療；對病人預後有幫助，也可促進醫病溝通，促使信任關係的建立；會客時間的制定應有彈性，在病人及家屬需求、醫療人員臨床常規間達成共識及取得平衡，而非一個通用的會客規定套用在每一位病人身上，以達成病人、家屬、醫療人員三贏局面。

The traditional Intensive Care Unit (ICU) visiting policies designed a restricted visiting policy based on the theory that family visitation increases critically-ill patients' physiological and emotional stress, increase of risk for infection, and interferes with provision of care. Admission to the ICU is a stressful event for both patients and their families. Traditional visitation policies cause family separation and further increase the stress for both patients and their loved ones. Recent evidence suggested that the presence of the family members in the units does not negatively impact s patients' physiological status; furthermore, it reduces cardiovascular complications, produces less anxiety, creates a feeling of security, and improves communication between patients, families, and medical staff. There is a need to balance patients and their families' needs with medical staff’s needs to provide care. Flexible visiting policies will ultimately lead to more satisfied patients, families and medical staff.

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