提升NPGY學員Pig-tail引流管照護完整性

Improving Pigtail Drainage Tube Care Integrity Among Nursing Postgraduate Year 2 Students

陳尹甄(Yin-Chen Chen) ； 郭素真(Shu-Chen Kuo) ； 夏惠珍(Huei-Jhen Sia) ； 陳淑芬(Shu-Fen Chen)

《榮總護理》 35卷2期 (2018/06) Pp. 185-194

https://doi.org/10.6142/VGHN.201806_35(2).0008

摘要

NPGY學員照護Pig-tail管路連續出現三起異常滑脫，管路滑脫率達過去一年的12倍，突顯照護上的危機。本專案小組對此進行分析原因，發現pig-tail引流管照護教學資源無專一性、分散於護理處置規範與網路護理指導中，且其內文多為文字敘述、管路固定方式無統一、學長姐以口頭傳授相關知能等。故於2015年4月開始進行多元教學策略，包括：(一)提供模組實際演練(Pig-tail引流管固定方式操作)，並設計易記誦的口訣，加深學員學習印象；(二)設計多媒體教材(Pig-tail引流管照護及固定教學影片)刺激學習動機，強化照護知能；(三)舉辦跨領域個案討論會，以團體互動、問題導向學習。專案活動執行後，管路達零滑脫、學員對管路照護完整性增加至94%、DOPS評量管路照護技術完整性提升至91.5%，且在課堂中充分運用批判性思考來執行情境上的決策，有效地培育出學員品質改善能力及動機，全體學員對此活動皆給予極高評價。

關鍵字

教學策略 ； NPGY學員 ； Pig-tail

並列摘要

Two cases of pigtail drainage tube slippage resulting from student error in postgraduate year 2 (NPGY) have occurred in Taiwan since January 2015. NPGY students mostly rely on apprenticeship training when learning how to care for pigtail drainage tubes. However, such a method is unsuitable for two reasons. One is that it lacks content coherence, and the other is that the necessary step-by- step picture-literacy guidance is missed. This directly affects NPGY students' manipulation of pigtail drainage tubes and damages nursing quality. Teaching strategies designed to remedy these problems were proposed in April 2015 and included the following: (a) designing teaching materials with digital video (pigtail drainage tube maintenance and instructional videos) to improve nurses' learning motivation and enhance overall knowledge and ability; (b) holding a cross-discipline instructional lecture by the nurse, respiratory therapist and chief resident of the division of thoracic oncology; (c) providing a practical biomimetic exercises module on fixing pigtail drainage tubes and one-on-one rehearsals with simulated pigtail tubes. Results of implementing these teaching strategies revealed that the rates of pigtail drainage tube slippage decreased from 2.86% to 0%. Means of integrity check list scores for pigtail drainage tubes were increased from 57.7% to 91.5%. Among NPGY students, the rate increased from 78.6% to 94%. All of the participants rated the teaching strategies highly. These results indicate that student-centered multiple teaching strategies should be further adopted.

並列關鍵字

diversified teaching strategies ； postgraduate year 2 students ； pigtail

參考文獻

王拔群、石崇良、林仲志、楊漢湶、翁惠瑛、李偉強(2007)．台灣病人安全通報系統中管路滑脫事件之分析．醫療爭議審議報導系列，27，33-41。

周繡玲、黃慧玲、王惠貞(2003)．降低豬尾巴及經皮穿肝膽道引流管路滑脫之專案．護理雜誌，50(5)，37-46。

周佳慧、雷若莉、陳淑齡(2014)．從新手至熟練臨床照護能力之轉換歷程．榮總護理，31(3)，276-285。

侯一欣、詹郁萱(2011)．N世代的學習問題及其對學校教育革新的啟示．教師專業研究期刊，2，1-18。

洪慧君、遲毓芬、連金延(2013)．提升腹部手術病人下床活動管路照護之完整性．榮總護理，30(2)，206-213。