A型流感合併急性呼吸衰竭病人之急診護理經驗

A Study of Nursing Experience of Caring an Influenza A Patient with Acute Respiratory Failure in Emergency Department

劉千璟(Chien-Ching Liu) ； 曾彥菁(Yen-Ching Tseng) ； 林純臻(Chun-Chen Lin) ； 盧美言(Mei-Yen Lu)

《新臺北護理期刊》 22卷1期 (2020/03) Pp. 127-135

https://doi.org/10.6540/NTJN.202003_22(1).0012

摘要

本文描述一位A型流感合併急性呼吸衰竭而緊急放置氣管內管病人之護理過程，筆者照護期間自2016年02月13日至02月15日，藉由實際照護、觀察、會談的方式收集資料並進行身體評估，運用Gordon十一項功能性健康評估，確立個案健康問題有：體溫過高、低效型呼吸型態、焦慮。於護理過程中給予個別性之護理措施，緩解體溫過高的不適，維持足夠氧合濃度，減少疾病造成身體的損傷，改善其生理問題；運用多媒體網站及單張提供流感相關衛教，增強疾病認知及照護上的因應能力，並主動聯繫關懷師前來陪伴與祝禱，提供靈性照護，以降低心中的不安及焦慮問題，使個案及家屬更有信心與勇氣面對治療計劃。但礙於急診照護性質及時間因素，護理人員無法投入更多心思探討病人及家屬的心理層面，乃照護上之限制，建議急診照護團隊可納入社工師的角色，不僅可與臨床護理師分工合作，更可展現醫療團隊完善的照護成效，進而提升急診照護品質與病人家屬滿意度，也期望藉由此次的照護經驗分享，提供急診護理人員未來照護類似病人之參酌。

關鍵字

A型流感 ； 急性呼吸衰竭 ； 急診

並列摘要

The purpose of this article was to explore a nursing experience in emergency for a patient with influenza A complicated with acute respiratory failure. The nursing period was from February 13^(th) to 15^(th) , 2016. With Gordon's 11 functional health patterns assessment tool and the patient's physical assessment, the patient's care problems were identified as hyperthermia, ineffective breathing patterns and the anxiety. We provided individual care to relieve the discomfort of hyperthermia; maintain adequate oxygenation concentration, reduce physical damage caused by disease, improve physiological problems and understand the emotions of family members through active care and empathy, use the Centers for Disease Control multimedia website and leaflets to provide flu-related education, invite family members to participate in the care plan to understand the disease cognition and increase the ability to respond to care, and contact the hospital caretaker to accompany and pray. We also Provide spiritual care to reduce anxiety and give patient and families more confidence and courage to face treatment. However, due to the time limitation of emergency care, it was hard to explore the psychological aspects of patient and their families. So we recommend that the emergency care team can include social worker to demonstrate better care of the medical team to improve the quality of emergency care and the satisfaction of patients' families. Hopefully, this nursing experience can serve as a reference for the care of such patients.

並列關鍵字

Influenza A ； Acute respiratory failure ； Emergency department

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