運用跨團隊整合照護一位急性心肌梗塞病人脫離呼吸器之護理經驗

Nursing Experience of Using Cross-Team Integration to Care for a Patient With Acute Myocardial Infarction Off of a Ventilator

劉芳君(Fang-Jun Liu) ； 洪秀玉(Hsiu-Yu Hung) ； 戴雪萍(Hsueh-Ping Tai)

《榮總護理》 38卷4期 (2021/12) Pp. 422-428

https://doi.org/10.6142/VGHN.202112_38(4).0011

摘要

本文探討一位因急性心肌梗塞合併呼吸衰竭，運用跨團隊整合照護及胸部復健運動成功脫離呼吸器之護理經驗。護理期間自2019年11月8日至12月8日，運用Gordon十一項健康功能評估病人有呼吸機戒斷反應功能失常、焦慮、照顧者角色緊張健康問題。照護期間運用跨團隊整合照護與家屬開立家庭會議，向病人及家屬說明呼吸訓練計畫，配合胸部復健運動增加呼吸肌耐力，教導深呼吸咳嗽技巧；與病人建立良好護病關係，鼓勵病人表達心中疑慮，結合專業團隊給予病情解釋，正向鼓勵與心理支持；教導主要照顧者照護技巧，緩解焦慮及壓力，幫助病人成功脫離呼吸器，希望藉照護經驗，提供日後臨床照顧類似病人應重視病人及主要照顧者生心理各方面的調適，以達到全人、全家、全程、全隊之完整照護品質。

關鍵字

心肌梗塞 ； 跨團隊照護 ； 脫離呼吸器

並列摘要

We present the experience of nursing a patient who had been successfully weaned off ventilator support. Cross-team integrated care and chest rehabilitation exercises were implemented after acute myocardial infarction and respiratory failure. Between November 8 and December 8, 2019, the Gordon functional health patterns were used to assess the health problems of patients experiencing symptoms, including anxiety, after ventilator withdrawal as well as the stress of the caregiver role. Nursing care included cross-team integrated care, meetings with family members, explanations of breathing training plans to patients and family members, assistance with chest rehabilitation exercises to increase respiratory muscle endurance, and training in deep breathing and coughing skills. In addition, establishing a positive care relationship with patients, encouraging patients to express doubts, professionally explaining the condition, providing positive encouragement and psychological support, training the main caregivers in care skills, relieving anxiety and stress, and successfully weaning patients off ventilators were key tasks. The results of this study can strengthen clinical care for similar patients and support caregiver psychological adjustments, thus achieving a high quality of care for the patient, family, and nursing team.

並列關鍵字

myocardial infarction ； cross-team integrated care ； ventilator weaning

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