提升護理人員靜脈內植式輸液塞換藥護理技術完整率

A Project of Improving the Rate of Completion of Changing Dressing Skills of Intravenous Port-A

施寧怡(Wen-Chen Chi) ； 鄭惠方(Jen-Jiuan Liaw) ； 余秀玲(Chung-Tay Yao) ； 蔡芸芳(Hsiu-Ling Chou)

《腫瘤護理雜誌》 6卷2期 (2006/12) Pp. 43-52

https://doi.org/10.6880/TJON.200612_6(2).05

摘要

護理專業攸關著病患安全，明確的標準與管控，是爲確保護理照護的水準。本專案的主旨爲提升靜脈內植式輸液塞(Port-A)換藥護理技術的完整率。經由現況分析發現，病房護理人員Port-A換藥護理技術完整執行率偏低的原因包括：（一）未設立port-A換藥護理技術標準操作規範，無詳細的操作步驟與解說；（二）在職教育未安排正式課程，故護理人員不熟悉port-A換藥護理技術；及（三）未定期查核。故依據相關文獻製作Port-A換藥技術標準操作規範、實例操作、製作圖片式資料後，藉由此專案對21位腫瘤科病房護理人員予以宣導及回覆示教並定期查核。專案執行後護理人員之Port-A換藥護理技術執行完整率由65.87%提高爲89.47%，但其未達目標100%，主要原因在於無菌技術上仍需繼續改進。專業護理技術經年維持完整是一件艱難任務，需有共識並定時品質監控，才能達到專業護理品質。

關鍵字

靜脈內植式輸液塞 ； 換藥護理技術 ； 完整率

並列摘要

Professional nursing care is closely related to patient safety. Working with a standard and a guideline ensure the quality of nursing care. Our project is to improve the rate of completion of changing dressing intravenous port-A. From observing the current clinical situation, we found three major factors causing low rate of completion of changing dressing intravenous port-A: (1) there was no operative standard for the care of changing dressing intravenous port-A; (2) there was lack of clinical curriculum in practical nursing education, so that nursing staffs were not well-trained with the procedures of changing dressing intravenous port-A; and (3) there was no regular audit. After reviewing the related literatures, we designed the standard operative procedure for changing dressing intravenous port-A; we made a practical example of changing the dressing and a procedure manual with pictures. By following this project, 21 nurses participated into the training under guidance, supervision and regular audit. After following this project, their rate of completion of changing dressing intravenous port-A improved from 65.87% to 89.47%. Reaching the golden standard of 100% completion rate requires the improvement of the disinfection technique. It is a difficult task to maintain the completion of nursing cares all the time. Having an agreement and regular quality audit, professional nursing care may reach their excellence.

並列關鍵字

port-A ； changing dressing skills ； completion rate