運用多元策略提升肝臟移植術後病人用藥認知

背景：接受肝臟移植術後病人須終身服用免疫抑制劑藥物來維持植入新器官功能，臨床調查，接受肝臟移植術後病人回診時發現有藥量剩餘或不足等情形，進而發現對移植術後用藥認知低。分析原因有：術後身體狀態影響學習成效；無持續評值監控肝臟移植術後病人藥物認知機制；衛教指導工具不夠完善及未符合病人需求。目的：肝臟移植術後病人用藥認知正確率由改善前68.3%提升至91%以上；肝臟移植術後病人用藥指導滿意度由改善前63.0%提升至85%以上。解決方案：介入措施包括：設計肝臟移植藥物衛教單張「幸福來的肝肝好用藥日誌」、藥物創意口訣與影片、互動式動畫認知及測試、擬定肝移植病人藥物認知監測機制等措施。結果：肝臟移植術後病人藥物認知正確率由68.3%提升至92.5%及對藥物衛教滿意度由63.0%提升至87.2%。結論：藉由多元策略的衛教方法，來提升肝臟移植術後病人用藥認知，亦在病人用藥安全上更顯護理卓越性。

關鍵字

多元策略；用藥認知；肝臟移植術後

並列摘要

Background & Problems: Patients with liver transplantation must take lifelong immunosuppressant medication to maintain the function of their hepatic graft. Based on clinical experience, we found that these patients were affected by both insufficient and remaining medication when they returned for outpatient service visits. After investigating the current situation, It was found that post-transplantation perceptions regarding medication were low in this patient group. After analysis, the identified causes of this included: (1) poor learning effect due to the interference from the multiple therapeutic catheter placement postoperatively; (2) delayed timing of assessing the awareness of information or perception of medication and lack of a post-operative follow-up mechanism; and (3) insufficient educational tools and materials for patients. Purposes: This study was designed to increase medication awareness from the current average of 68.3% to > 91% and to increase patient satisfaction with medication guidance from the current 63.0% to > 85% in patients who had received liver transplantation. Resolutions: The improvement strategy included: designing a health education sheet including related medication information and a daily medication record; designing a mnemonic, interactive video, or test to improve medication perception; creating measures associated with a monitor mechanism to assess medication knowledge. Results: After strategy implementation, medication awareness increased from 68.3% to 92.5% and satisfaction with medication guidance increased from 63.0% to 87.2%. Conclusions: The implementation of several strategies concurrently can enhance medication awareness in patients after liver transplantation and increase patient satisfaction with medication guidance.

並列關鍵字

multiple strategies ； medication cognition ； post liver transplantation

參考文獻

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運用多元策略提升肝臟移植術後病人用藥認知

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