提升護理人員執行希克曼導管居家照護衛教正確率

Enhance the Accuracy of Nursing Staff Performing Hickman Catheter Home Care Nursing Instructions

謝宜均(Yi-Chun Hsieh) ； 林曉芳(Hsiao-Fang Lin) ； 周小玉(Hsiao-Yu Chou)

《領導護理》 24卷2期 (2023/06) Pp. 145-159

https://doi.org/10.29494/LN.202306_24(2).0011

摘要

本單位平均每月慢性腎衰竭病人約有60%病人使用希克曼導管透析，每月新放置希克曼導管病人數約為12人。返家後，針對具備能力照顧者會衛教導管護理方式並回覆示教，現況調查中發現因未制定希克曼導管居家照護衛教標準流程導致護理人員不知道衛教內容是否正確及合適，衛教過程反覆及費時，故為引發本專案探討動機。專案期間為2021年1月10日至2021年4月30日，發現護理人員執行希克曼導管居家照護衛教正確率僅73.7%，經開立護理衛教共識會達到衛教共識後並建立查核機制、衛教手冊、衛教影片及模擬道具包等輔助工具並使用直接觀察操作型技術評量法及翻轉教學策略，使護理人員執行希克曼居家照護正確率由提高至93.1%，達到設立專案之目標，期望藉由提升管路安全及增進護病關係，進而提高臨床護理人員執行希克曼導管居家照護衛教正確率，促進透析病人返家後生活品質。

關鍵字

希克曼導管 ； 居家照護衛教 ； 血液透析

並列摘要

On average, about 60% of the chronic renal failure patients in our unit use Hickman catheter for dialysis every month, and the number of new Hickman catheter patients is about 12 per month. After returning home, the competent caregivers will teach the nursing methods and respond to the training. The current situation investigation shown that the nursing staff did not know whether the content of the health education is correct or appropriate because the standard process of Hickman catheter home care and education has not been formulated. The process of health education is repetitive and time-consuming, hence motivated the discussion of this project. The project period was from January 10 to April 30, 2021. It was found that the correct rate of nursing staff implementing Hickman catheter home care education was merely 73.7%. After the establishment of the Nursing and Health Education Consensus Meeting, the consensus on health education was reached, and auxiliary tools such as an assessment mechanism, health education manuals, health education videos, and simulation props were generated. By using direct observation and operation-based technical evaluation method and flipped teaching strategy, the accuracy rate of nursing staff in implementing Hickman's home care has increased to 93.1%, reaching the goal of this project. It is hoped that by upgrading the safety of the pipeline and enhancing the relationship between nurses and patients, the correct rate of clinical nurses performing Hickman catheter home care and health education will improve, and the quality of life for dialysis patients will get better after returning home.

並列關鍵字

Hickman catheter ； home care nursing instructions ； hemodialysis

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