運用醫病共享決策輔助工具提升脊椎壓迫性骨折治療認知正確率

Using Medical Disease Shared Decision-Making to Improve Recognition Accuracy of Spinal Compression Fractures

沈桂鳳(Kuei-Feng Shen) ； 趙嘉玲(Chia-Ling Chao) ； 陳玉婕(Yu-Chieh Chen)

《高雄護理雜誌》 36卷2期 (2019/08) Pp. 28-40

https://doi.org/10.6692/KJN.201908_36(2).0003

摘要

脊椎壓迫性骨折的治療方式非常多元，醫護人員需充分告知可選擇的治療方式，讓病人及家屬能夠即時掌握治療方式，做出正確的醫療決策，進而提升醫療照護品質。於2017年08月01日至2018年08月30日期間，經本病房現況分析發現：醫師因工作忙碌，簡化解釋內容、缺乏病情解釋之輔助工具、缺乏病情吿知作業流程，導致病人對於脊椎壓迫性骨折治療認知及執行脊椎壓迫性骨折治療說明之完整率偏低。本專案目的藉由實證資料庫檢索脊椎壓迫性骨折最佳實證治療方針、制定醫病共享決策輔助工具及標準化作業流程等措施，來提升病人對脊椎壓迫性骨折治療認知及醫療團隊人員執行脊椎壓迫性骨折治療說明之完整。於2018年06月01日至2018年07月31日期間執行結果顯示脊椎壓迫性骨折治療認知正確率由70.0%提升至98.8%和醫療團隊成員醫執行脊椎壓迫性骨折治療說明之完整率由71.0%提升至100%，已達本專案目標設定。

關鍵字

脊椎壓迫性骨折 ； 骨水泥椎體成形術 ； 醫病共享決策

並列摘要

There are many treatments for spinal compression fractures. Medical staff need to be fully informed about the treatment options that can be selected so that patients and their families can immediately understand the treatment methods, make correct medical decisions, and help improve the quality of medical care. During the period from August 01, 2017 to August 30, 2018, it was found through the analysis of the current situation of the ward: due to the physician being busy with the work, a simple explanation of the treatment process, with the lack of auxiliary tools to explain the condition and work flow to inform the condition, the accuracy rate of the patient's recognition of spinal compression fracture treatment and the implementation of the complete rate of spinal compression fracture treatment instructions was not completely satisfactory. The purpose of this project was to use an empirical database to search for the best empirical treatment guidelines for spinal compression fractures, to develop a shared decision-making auxiliary tool and standardized procedures to improve the accuracy rate of the patient's recognition of spinal compression fracture treatment and the implementation of spinal compression fracture treatment instructions. The results of the implementation rate from June 01, 2018 to July 31, 2018 showed that the patient's awareness of the spinal compression fracture treatment increased from 70.0% to 98.8% and the implementation of spinal compression fracture treatment instructions increased from 71.0% to 100%, which reached the target setting of this project.

並列關鍵字

spinal compression fractures ； vertebroplasty ； shared decision-making

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