股骨骨折患者術後延遲復健的改善方案

The Plan to Promote the Initiation to Leave the Bed for Rehabilization in Postoperated Patients Suffering from Femoral, Fracture

廖翎聿(Lin-Yu Laiw) ； 吳重慶(Chung-Chieng Wu) ； 陳秋蘭(Chiu-Lan Chen) ； 高鳳吟(Fong-Ying Kao) ； 曾腎洲(Hsien-Chou Tseng)

《秀傳醫學雜誌》 6卷1&2期 (2006/06) Pp. 67-72

摘要

To leave the bed for early rehabilization as soon as possible after the surgical manipulation is the best but the only way to recover completely or almost completely for postoperated patients suffering from femur fracture. Prolonged bed-lying is not only harmful for early recovery, but also usually leads to complication (s) of various severity, even results in a lethal outcome. Wu has found the leading causes of a prolonged bed-rest after surgery for the femur-fratured patients included patients/family misconcept and/or mis-knowledge, nurses undergone incomplete professional education and/or trainting, and inadequate central supervision. We thereafter, according to the PDCA principle, demonstrated a new system, a complete plan, showing an accurate definition of initiation time to leave the bed after surgery, a claim-board of professional aids, a clear-cut responsibility for postoperative professional aids, a complete supervision system for follow-up, an intensive in-job continuous training course, a guidebook in detail for initiation on postsurgery rehabilization, and an active bed-side professional aiding system. With the performance of the new system, the t-time (the initiation time to leave the bed postoperatively) was prominently shortened form 141±4.9 hours to 69.0±2.7 hours (p＜0.01); and, percentage of patients/family with misconcept/mis-knowledge was changed from 100%(30/30) to 13%(4/30). Undoubtedly, our plan was successful in its promoting phase. This new system is now carried out as a rule for an ordinary daily management mode, under the SDCA priniciple.

關鍵字

股骨骨折 ； 術後復健 ； 首次下床 ； 解決方案 ； PDCA ； SDCA

並列摘要

To leave the bed for early rehabilization as soon as possible after the surgical manipulation is the best but the only way to recover completely or almost completely for postoperated patients suffering from femur fracture. Prolonged bed-lying is not only harmful for early recovery, but also usually leads to complication (s) of various severity, even results in a lethal outcome. Wu has found the leading causes of a prolonged bed-rest after surgery for the femur-fratured patients included patients/family misconcept and/or mis-knowledge, nurses undergone incomplete professional education and/or trainting, and inadequate central supervision. We thereafter, according to the PDCA principle, demonstrated a new system, a complete plan, showing an accurate definition of initiation time to leave the bed after surgery, a claim-board of professional aids, a clear-cut responsibility for postoperative professional aids, a complete supervision system for follow-up, an intensive in-job continuous training course, a guidebook in detail for initiation on postsurgery rehabilization, and an active bed-side professional aiding system. With the performance of the new system, the t-time (the initiation time to leave the bed postoperatively) was prominently shortened form 141±4.9 hours to 69.0±2.7 hours (p＜0.01); and, percentage of patients/family with misconcept/mis-knowledge was changed from 100%(30/30) to 13%(4/30). Undoubtedly, our plan was successful in its promoting phase. This new system is now carried out as a rule for an ordinary daily management mode, under the SDCA priniciple.

並列關鍵字

femoral fracture ； postoperative rehabilization ； initiation time to leave the bed ； plan ； PDCA ； SDCA