- 期刊
提升心臟外科病房護理人員執行居家型心室輔助器照護流程完整率
Improving the Completeness of the Nursing Process for Home-style Ventricular Assist Device in Cardiac Surgical Ward
摘要
接受心臟移植是末期心衰竭病人延長生命最佳方式，在未等到心臟移植前，可藉由裝置心室輔助器來維持生命。訪談臨床護理人員照護此類病人時壓力大，因臨床此類個案數不多，已致單位護理人員照護經驗不足及照護流程不熟悉，分析原因：醫囑開立不完整、無核對項目之表格、多種居家型心室輔助器操作不熟悉、流程未修訂、無標準作業規範、無定期舉辦在職教育，人員對於居家型心室輔助器認知僅達78.0%，執行照護流程完整率為82.4%。改善措施：運用多媒體教學影片，制定標準化手冊、圖示卡、舉辦教育訓練、運用醫囑範本及評估檢視表。結果：人員照護認知調查由78.0%提升至95.8%，執行照護流程完整率由82.4%提升至100%，有效提升護理人員對居家型心室輔助器照護流程完整率。
關鍵字
居家型心室輔助器並列摘要
Cardiac transplantation is the major treatment for end-stage heart failure patients. Ventricular assist device (VAD) support may be a choice of bridge prior to cardiac transplantation to extend lifespan. After interviews with nurses, ward staffs were stressful and unskillful in providing healthcare to these VAD patients in cardiac surgical ward. Those were caused by multiple factors including lack of clinical experience due to few VAD patients and unfamiliarity with the way of healthcare providing. Nurses in cardiac surgical ward often frustrated in incomplete doctor's order, various home-style VADs, lack of a standard operating procedure, no paucity of related on-job education, and lack of a thorough nursing checklist. Purpose: This project aimed to improve the knowledge of various home-style VAD and the completeness regarding nursing process for various home-style VAD in cardiac surgical ward. Resolutions: This project applied the use of multimedia teaching video, established standardized instruction handbook, flashcards and manual checklist, held regular educational programs, and established template of doctor's order. These procedures were used to assist ward staffs to obtain sufficient knowledge and to be familiar with various home-style VAD care. Results: By implementing these aggressive activities, the accuracy improved staffs' knowledge regarding VAD and the completion rate for associated care procedure from 78.0% to 95.8% and from 82.4% to 100.0%, respectively. Strategies used here in VAD patient care were beneficial and effective to improve the completeness of various home-style VAD nursing process.