提升急性腦中風病人肌力之護理專案

A Nursing Project on the Improvement of Muscle Strength of Acute Stroke Patients

翁淑敏(Shu-Min Weng) ； 林瑞青(Ruei-Ching Lin) ； 林琦峯(Chi-Feng Lin) ； 林佳慧(Chia-Huei Lin)

《源遠護理》 12卷1期 (2018/03) Pp. 36-45

https://doi.org/10.6530/YYN/2018.3.1

摘要

腦中風疾病嚴重者除可能致死外，最大後遺症便是腦神經功能損傷後造成肢體偏癱及生活失能，因此若能在發病早期即時介入復健，不僅能減緩失能程度，更能幫助患者重返工作、回歸社會。本單位為腦中風專科病房，101年病房內成立獨立腦中風復健室，並發展一套早期住院復健計畫，以提升方便性、可近性及完整性之運動復健活動，提高病人從事復健之意願。然而現況發現不僅復健室使用率低，病人出院時肌力狀況及生活功能改善程度有限，故成立專案小組期望增加腦中風病人出院時的肌力及提升復健照護品質。經文獻查證、實際觀察和專案小組討論，歸納問題主要為：護理人員不了解腦中風復健流程、缺乏腦中風病人復健作業規範及復健相關衛教資料不完整。專案擬定對策實施方案分別為：制定腦中風復健運動流程、舉辦教育訓練以提升護理人員復健照護之專業技能，護理人員對腦中風患者肌力提升之認知、修訂腦中風復健紀錄單，腦中風復健室使用規範、製作腦中風復健照護指引光碟與復健圖片衛教單，追蹤成效顯示腦中風復健室使用率提升為80.4%、腦中風復健紀錄單完整率提升達83.3%、腦中風病人肌力提升達75%，顯示本專案能有效提升腦中風病人肌力，改善腦中風病人住院中復健照護品質。

關鍵字

腦中風 ； 復健 ； 肌力 ； 護理專案

並列摘要

Serious stroke may results in death or damage to neurological functions, including hemiparesis and disability. Early rehabilitative intervention after stroke might reduce the severity of disability and help patients to resume social and work functions. In 2012, the stroke care ward setup a stroke rehabilitation room and an early rehabilitation program to provide convenient, accessible, and complete rehabilitation training for stroke patients aiming at promoting patients' motivation and engagement. Initial data showed low rehabilitation room utilization and limited improvement of muscle strength and functional status among discharged patients. The purpose of this study was to improve patients' muscle strength and quality of rehabilitation care for stroke patients. Investigation through literature review, clinical observation and discussion indicated that the major causes were nursing staff lack of awareness and lack of standard of procedure and educational materials on stroke rehabilitation program. Strategies included (1) development of a stroke rehabilitation protocol, (2) staff training on rehabilitation skills, (3) revision of rehabilitation record and norms for using the stroke rehabilitation room, and (4) creation of a CD-ROM of stroke rehabilitation guidelines and education material with pictures. Results showed that the rehabilitation room utilization rate increased to 80.4%, the completion of rehabilitation record increased to 83.3% and stroke patients' muscle strength improved to 75%. Results indicated that the interventions improve stroke patients' muscle strength and quality of rehabilitation care.

並列關鍵字

stroke ； rehabilitation ； muscle strength ； nursing project

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