提升住院病人首次接受血液透析護理指導完整率

治療前進行完整的護理指導可減輕病人對治療與照護的焦慮並提升自我照顧能力。統計本單位2019年11月－2020年3月護理指導完整率僅59.6%，經調查護理指導不完整原因為：護理人員因忙碌而忘記護理指導、透析中衛教時護理師被其他病人叫喚而中斷、護理師憑經驗衛教缺乏一致性、病人因透析中不舒服而未執行護理指導、部份護理指導沒有衛教單張、衛教單張字體不合適且都是文字缺乏圖表說明、介入護理指導時機太晚、缺乏護理指導後交班與查核機制。透過文獻查證後選定七項改善對策：修訂護理指導執行內容、規劃交班內容並將衛教紀錄單資訊化導入提醒設計、審閱與制定衛教單張並集結成透析前訪視手冊、新增首次血液透析前訪視護理指導方式、制定護理指導查核作業、製作多媒體影片、QR code連結指導單張及影片。經改善對策後，住院病人首次接受血液透析護理指導完整率由59.6％提升至100％，並間接提升病人滿意度，達本專案目標且對護理照護品質有正面肯定。

關鍵字

首次血液透析；護理指導；完整率

並列摘要

This project is aiming to increase the integrity rate of the nursing instruction for the first time hospitalized patients hemodialysis. complete rate of nursing instruction can reduce patients' anxiety about their treatment and care as well as improve their self-care ability. Statistic showed, from November 2019 to March 2020, the Integrity rate of nursing instruction was only 59.6%. After clinical investigation, incomplete nursing instruction is the cause, nine improvement countermeasures were provided after literature review they are: revising the implementation content of nursing instruction, specifying guidance items to be included in the shift handover, formulating health education leaflet, making the pre-dialysis visit pamphlet and multimedia video, Standardizing the information and reminder design of health education recording sheet, adding nursing instruction for the first Pre-hemodialysis visit, developing nursing guidance inspection program and QR code linked guidance leaflet and videos. After these strategies were executed, the complete rate of the first time hospitalized patients receiving hemodialysis nursing instruction increased from 59.6% to 100%, and the patient satisfaction has been indirectly improved. This project successfully achieved its objectives, and the quality of nursing care was also improved positively.