結合復健資源提升內科加護病房足部復健運動執行率

Incorporate Rehabilitation Resources to Improve the Execution Rate of Foot Rehabilitation Exercises in the Internal Medicine Intensive Care

林雅雯(Ya-Wen Lin) ； 李慧芝(Hui-Chih Lee) ； 李靜芳(Ching-Fang Lee)

《領導護理》 21卷2期 (2020/06) Pp. 116-127

https://doi.org/10.29494/LN.202006_21(2).0010

摘要

家屬對病人足部乏力及水腫提出抱怨，引發專案動機。現況發現缺乏明確的足部復健運動之啟動機制及流程、團隊缺乏溝通與合作，缺乏合適的輔助工具及護理人員對足部復健認知低導致內科加護病房足部復健運動執行率低（27%）。共識及參閱文獻後設定執行率提升至80%。經制定足部復健運動機制及流程、安排足部復健運動教育課程、提供合適的輔助工具及創新設計足部復健運動、編製足部關節運動示範片及衛教單、制定足部復健評估及記錄單與定期舉辦團隊討論會，使執行率提升至95%，並增加護理人員對足部復健運動認知、態度與技能，足部水腫發生率由59.6%降至32.3%。顯示專案改善具效益，效果維持95%以上，可平行推展至其他單位。

關鍵字

復健資源 ； 足部水腫 ； 足部復健

並列摘要

This project was motivated by complaints from family members regarding the foot weakness and edema experienced by the patient. At present, there is a lack of clear mechanism and process for initiating the foot rehabilitation exercise; lack of communication and cooperation between different teams; lack of suitable auxiliary tools; and the lack of awareness about foot rehabilitation among the nursing staff, and all of those have contributed to the low rate (27%) of execution of foot rehabilitation exercise in an internal medicine intensive care unit. After reaching consensus and referring to the literature on this subject, a target of 80% was set for the implementation rate. After formulating the foot rehabilitation exercise education courses, providing appropriate auxiliary tools and innovative design of the foot joint exercise demonstration film and health education leaflet; regular team discussions was held to improve the implementation rate to 95%. Furthermore, by improving the nursing staff's awareness, attitude, and skills in regards to foot rehabilitation exercise, the incidence of foot edema was lowered from 59.6% to 32.3%. These results indicated the effectiveness of the project implementation. If the rate can be maintained at 95% or higher, this project can be extended to other units in parallel.

並列關鍵字

rehabilitation resources ； foot edema ； foot rehabilitation

參考文獻

王靜怡、陳惠雅、胡名霞（2012）．社區預防性復健照護的物理治療服務．台灣醫學，16(6)，606- 615。doi:10.6320/FJM.2012.16(6).05

李皎正、鍾聿琳（2012）．談護理臨床教育．護理雜誌，59(5)，5-9。 doi:10.6224/JN.59.5.5

張媚、余玉眉、趙可式（2012）．從民眾健康需要看台灣護理教育的挑戰與對策．護理雜誌，59(5)，10-15。doi:10.6224/JN.59.5.10

陳宛伶、賴禹璇、林聖哲、邱淑芬、王時傑、江東懋（2012）．運用醫品圈手法提升腦中風病人住院期間病房復健活動執行率．醫務管理期刊，13(1)，64 -77。doi:10.6174/JHM2012.13(1).64

Calvo-Ayala, E., Khan, B. A., Farber, M. O., Ely, E. W., Boustani, M. A. (2013). Interventions to improve the physical funtion of ICU survivors-A systematic review. Chest, 144(5), 1469-1480. doi:10.1378/chest.13-0779