- 學位論文
臨床護理人員對手術前禁食的知識程度與影響因素
Exploration of clinical nurses’ perception of preoperative fasting and the affecting factors
摘要
手術前禁食長達6-8小時仍然是外科手術患者的常見臨床做法。手術前禁食的目的是麻醉誘導期間防止肺部誤吸，改善腸道準備及手術後噁心或其他與手術相關併發症的發生。然而，延長手術前空腹時間會增加全身代謝和術後胰島素拮抗造成血糖上升等反應。研究結果顯示出臨床護理師在手術前禁食的態度及專業知識。本研究是以台灣南部某醫院進行的一項基於問卷調查的前瞻性，橫斷面的調查。問卷結果 321 人中共有214 人完成接受問卷調查，問卷回收率為 67%，研究結果發現：(1)是否參加過手術前禁食講座的干預不會影響護理師的正確反應率；(2) 是否參加過手術前禁食介入講座會影響護理師總體正確反應率；(3) 具有較高學歷和較資深臨床經驗的護理師得分明顯高於資歷較淺的護理師。根據研究結果顯示，應根據臨床護理師的資歷及學歷水平來進行手術前禁食的在職護理培訓，以提高講座的有效性。
並列摘要
Preoperative fasting up to 6-8 h remains a common clinical practice in surgical patients. The aim of perioperative fasting is to prevent pulmonary aspiration during anesthesia induction, improve bowel preparation, and ameliorate the development of postoperative nausea/vomiting or other surgical-related complications. However, prolonged fasting during the perioperative period has been shown to induce profound systemic catabolic responses and development of insulin-resistant hyperglycemia. This study determined the attitude and professional knowledge of the clinical nurses in preoperative fasting. This was a prospective, cross-sectional, questionnaire-based survey conducted in a regional hospital at southern Taiwan. The questionnaire was distributed to 321 clinical nurses who cared for surgical patients in their regular work. The participants responded to the same questionnaire before and after taking an introductory lecture on perioperative fasting. A total of 214 effective completed questionnaire were finally collected, resulting in a recovery rate of 67%. Our results found that the intervention of lecture on preoperative fasting did not affect the overall correct response rate of the nurses. There were also no differences in the correct response rate between those who took the lecture and those who did not. The scores of clinical nurses who had higher academic degrees and longer practice experience were significantly better than the juniors. These findings suggest that on-the-job training in nursing care for preoperative fasting should be based on the levels of seniority and academic degrees of the clinical nurses to enhance the effectiveness of lectures.