提升腎臟移植術後自我照顧認之正確率

Enhance of Post Kidney Transplantation Self-Care Perception Rate

10.6530/YYN.201907_13(2).0006

郭靜霖(Jing-Lin Guo)；王翠華(Tzuei-Hua Wang)；黃佳翎(Jia-Ling Huang)；孫吟蓁(Yin-Jhen Sun)；蕭鵬卿(Peng-Ching Siao)

腎臟移植 ； 護理指導 ； 自我照顧 ； renal transplantation ； nurse guidance ； self-care

源遠護理

13卷2期（2019 / 07 / 01）

36 - 45

繁體中文

護理師最主要功能是腎臟移植者的評估者、諮詢者、教育者及代言者，根據個別性給予護理指導。臨床照護經驗中，發現單位護理師護理指導與執行缺乏一致且不完整，以致移植者自行停藥出現排斥症狀，而失去移植腎臟。因此，透過改善擬定四項解決辦法:制定護理指導標準作業、研發多元指導工具、制定總稽核與追蹤機制及設立腎臟移植專責護理師。腎臟移植者自我照顧認知正確率：由執行前54.2%提升至88.3%；腎臟移植術後護理指導完整率：由執行前56.1%提升至91.7%；護理指導滿意度：由執行前71.7%提升至95.5%，已達專案目標，護理師能完整執行護理指導，促使移植者全程參與，提升自我照護效能。

One of the most important nursing functions in the care of kidney transplant patients is individualized assessment, consultation, education and endorsement. This article reports an improvement project to resolve inconsistency in clinical practice of and documentation that resulted in negative outcomes of kidney rejection and loss of transplanted kidney. Improvement aspects are in the following: (1) standardized nursing instructions, (2) the development of multiple guidance tools, (3) implements audits and tracking mechanism, and (4) establishment of nurse specialty in kidney transplant care. Goals achieved after project implementation were: (1) kidney transplantation self-care perception rate increased from 54.2% to 88.3%; (2) post kidney transplantation nursing guidance completion rate increased from 56.1% to 91.7%; and (3) patient satisfaction toward nursing guidance increased from 71.7% to 95.5%. Nurses play an important role to implement the complete nursing guidance to promote full participation and to enhance self-care efficacy of the transplant patients.

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