改善鼻部手術病患麻醉恢復期躁動方案

A Project to Reduce Agitation in Post-Nasal Surgery Patients

曾淑如(Shu-Ju Tseng) ； 張淑芳(Shu-Fang Chang) ； 陳鳳玲(Feng-Ling Chen) ； 劉金屏(Chin-Ping Liu) ； 劉靜怡(Ching-Yi Liu)

《榮總護理》 28卷1期 (2011/03) Pp. 64-72

https://doi.org/10.6142/VGHN.28.1.64

摘要

鼻部手術病患因手術後氣管內管留置、使用鼻填塞物壓迫止血導致手術後躁動情形嚴重，常合併有鼻部出血、鼻填塞物滑脫、點滴脫落及皮膚破皮等不良事件發生。因此希望藉由本專案，縮短病患在麻醉恢復期的躁動時間。經問卷調查發現此類病患手術後躁動原因前三項為吸不到氣、疼痛和口乾。針對原因進行改善方案有：提供手術前衛教指導、手術後穴位按壓和自製冰檸檬水潤濕口腔等。執行改善措施，病患手術後躁動持續時間大於4分鐘以上的比率由82.6%下降至13.6%，達到專案設定的目標值41.3%。未來仍持續進行統計分析並隨時修正改善措施，落實病患的照護以達到最佳照護品質，維護病人安全。

關鍵字

鼻部手術 ； 躁動 ； 穴壓

並列摘要

Patients who receive nasal surgery often present to have severe postoperative agitation due to experience of endotracheal tube insertion and nasal packing compression. Thus, this leads to complications with nasal bleeding, dislodgement of nasal packing, drawing out of intravascular line, and surrounding cutaneous injury. This scheme was designed to reduce the incidence of postoperative agitation in such patients during recovery period from anesthesia. Through questionnaire investigation, it was found that the main causes were difficult in breathing, wound pain, and dry mouth. Thereafter, preoperative education, postoperative acupressure massage, and the use of iced lemon water in lubricating the mouth were applied. The result showed that the targets of this scheme of postoperative agitation duration lasting for more than 4 minutes happened to decrease from 82.6% to 13.6%. This data was even lower than the preset target threshold value of 41.3%.

並列關鍵字

nasal surgery ； agitation ； acupressure massage