提升癌症末期病人不施行心肺復甦術簽署率

To Promote the Signing Rate of DNR Consent among Terminal Cancer Patients Who Have Decided Not to Receive Resuscitation

鄭淑芬(Su-Fen Cheng) ； 丁肇慈(Chao-Tzu Ting) ； 郭彩雲(Tsai-Yun Kuo)

《榮總護理》 30卷1期 (2013/03) Pp. 29-37

https://doi.org/10.6142/VGHN.30.1.29

摘要

台灣每年有三萬餘人因癌症辭世， 簽署『不施行心肺復甦術』（Do not resuscitate, DNR）可免除急救過程所造成的痛苦。但本院非安寧病房之簽署率只有62.7%，故專案目的在提升癌末病人不施行心肺復甦術簽署率。經調查原因為「缺乏DNR 適當簽署時機的評估工具」、「護理人員角色功能不明確，未列入DNR簽署流程」及「醫師說明DNR的技巧不足」，經舉辦在職教育、使用緩和行為能力分級評估表（Palliative Performance Scale, PPS）作為簽署時機之評估工具、製作CPR衛教影片及問答諮詢題庫、並制定癌症末期病人簽署DNR指引，將護理人員角色功能列入DNR簽署流程，使得簽署率提升至80.82%，進而提升照護品質。

關鍵字

癌症末期 ； 不施行心肺復甦術 ； 評估工具

並列摘要

In Taiwan, more than thirty thousand people died from cancer every year. By consenting to ”Do Not Resuscitate(DNR)”, patients can be freed from unnecessary treatment and pain, but the consent rate has reached only 62.7% in a non-hospice ward of our hospital. Therefore, the purpose of the project is to increase the consent rate to DNR among the terminal cancer patients who have decided not to receive resuscitation. The results of the investigation were ”Lack of suitable assessment tools before consenting to DNR”, ”Roles and functions of the nurses in the non-hospice ward were not defined, also not included in the signing procedure” and ”Insufficient skills among doctors in indicating DNR”. We can not only increase the signing rate to 80.82%, but also raise the care quality through improving professional skills by using PPS as the assessment tool when signing DNR, producing health educational videos and data for Q&A, and providing indications for terminal cancer patients before signing DNR.

並列關鍵字

terminal cancer ； DNR ； assessment tool

參考文獻

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