提升護理人員執行正顎手術後之口腔照護完整性

Improving the Integrity of Executing the Oral Care by Nurse for Orthognathic Surgery Patient

黃瑜婷(Yu-Ting Huang) ； 蔡方瑋(Fang-Wei Tasi) ； 李美滿(Mei-Man Lee) ； 周素葉(Su-Yeh Chou) ； 邱綉玲(Hsiu-Ling Chiu) ； 黃慈心(Tzu-Hsin Huang)

《長庚護理》 28卷2期 (2017/06) Pp. 279-290

https://doi.org/10.3966/102673012017062802008

摘要

提升手術後病人衛教指導完整性是術後照護品質重要的一環。本專案主旨在提升護理人員執行正顎手術後口腔照護完整性及照護認知，以提升病人術後口腔照護滿意度。臨床上因病人於正顎術後有發生口腔感染，且護理人員衛教口腔照護內容不太一致造成病人抱怨，故運用問卷調查及實際觀察表收集資料，得知護理人員執行口腔照護完整性僅達80.8%，分析主要原因為：1.照護內容缺乏一致性。2.術後口腔照護內容不完善－無詳細教案可參考。3.未定期查核口腔護理技術。4.口腔護理準備用物不一致。經專案措施介入：1.擬定正顎手術口腔照護指引及查核機制。2.舉辦在職教育及實務訓練。3.口腔照護用物標準化。4.建置專用日用品包。專案實施後，護理人員執行口腔照護完整性提升至95.5%；口腔照護認知答對率68.5%提升至95.4%及病人術後口腔照護滿意度由3.9分提升至4.7分。透過此專案改善，有效提升護理人員執行正顎手術後口腔照護完整性，亦改善病人術後口腔照護滿意度。

關鍵字

正顎手術 ； 口腔照護 ； 執行完整性

並列摘要

Improving the postoperative patient health education guidance integrity is an important part of postoperative care quality. This Study attempted to improve the integrity of oral care and nursing recognition of nurses, and to raise the satisfaction of patients. Oral infection could occur among orthognathic patients after surgery and they would complain about the inconsistent oral care by different nurses. Therefore we conducted survey and collected data by questionnaires and observation to understand the problems. The survey indicated that the execution rate of oral care was merely 80.8%. The causes were: 1. lack of consistent care protocol; 2. lack of detailed nursing education materials; 3. no regular evaluation of skills of oral care; and 4. no stable supply of materials needed for oral care. The intervention measures included: 1. drafting the instructions and surveillance method of the post-orthognathic surgery care; 2. Setting up in-service education and practical training programs; 3. establishing standard supply for oral care; and 4. preparing daily essential caring pack. After implementing the project, the execution rate increased to 95.5%. The correct rate of oral care increased from 68.5% to 95.4%. The satisfaction level increased from 3.9 to 4.7. The project successfully improve quality of oral care and satisfaction level of patients.

並列關鍵字

orthognathic surgery ； oral care ； the integrity of executing

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