經腹股溝血管行心導管手術的術後護理傷口跟進計劃

Wound care program for patients undergone trans-femoral catheterization

吳浩迪(NG Hou Tek)；梁立彤(LEONG Lap Tong)

腹股溝血管 ； 心導管手術 ； 傷口跟進 ； 術後住院時間 ； Trans-femoral catheterization ； Wound care ； Length of hospital stay

鏡湖醫學

21卷1期（2021 / 06 / 01）

81 - 83+69

繁體中文;英文

目的：實行由護士主導的經腹股溝血管行心導管手術病人術後傷口院外跟進計劃，縮短病人因傷口問題延長住院時間。方法：於2018年9月～2019年4月實行術後傷口院外跟進計劃（跟進組n =27），內容包括：出院前病人及家屬傷口護理指導、派發健教單張、安排兩次出院後回病區傷口跟進服務（常規出院後第3天及第7天）或兩次傷口外展服務（行動不便病人），對比2018年1月～2018年8月該類病人住院時間（對照組n =25），觀察計劃效果。結果：兩組於年齡、性別、術式均沒有顯著性差異（P>0.05），術後平均住院時間：跟進組為4.4±1.8天、對照組為6.4±2.2天，具有顯著性差異（P <0.01），跟進組病人均未有發生手術部位感染，住院組發生1例手術部位感染。結論：經護士主導的傷口院外跟進計劃能有效減少病人術後住院時間。

Objective: Implementing a nurse-led quality improvement project for patients who undergone trans-femoral catheterization, which aim at promoting early discharge by providing a series of puncture wound nursing care for peri- hospital discharge. Methods: Baseline data of 25 patients with standard usual care was collected from January to August in 2018.The project was implemented from September in 2018 to April in 2019 for 27 patients. The intervention included: 1) provide nursing education and booklet to patient and caregiver before hospital discharge, 2) arrangement of puncture wound follow up on the third day and seventh day after hospital discharge (Community outreach services would be arranged if necessary). Results: No difference was found in age, gender and types of catheterization between group (P>0.05). There was a significant difference in length of hospital stay after catheterization between two groups (P<0.01). The average days of hospital stay for usual care group was 4.4±1.8 days and for interventional group was6.4±2.2days. One puncture site infective case was reported in usual care group. No puncture site infection was found in intervention group. Conclusion: The nurse-led puncture wound care improvement project for patients who undergone trans-femoral catheterization was effective to reduce length of hospital stay after catheterization.