經股動脈冠狀動脈介入術後病人腰背酸痛之改善專案

A Project to Decrease the Incidence of Back Pain in Postpercutaneous Coronary Intervention Patients

陳麗如(Li-Ju Chen) ； 吳家榛(Chia-Chen Wu)

《志為護理-慈濟護理雜誌》 11卷6期 (2012/12) Pp. 76-86

https://doi.org/10.6974/TCNJ.201212.0076

摘要

經股動脈冠狀動脈介入術後病人常抱怨腰背酸痛，本專案旨在探討病人腰背酸痛的原因，研擬解決之道，以提高照護品質。經分析發現：護理人員未主動評估及介入處理病人腰背酸痛問題、無PCI術後病人臥床期間可執行的活動指引、缺乏合適的翻身輔具、APTT檢驗效率欠佳，導致腰背酸痛發生率100%，酸痛分數達7.6±1.5分。於是擬定解決策略：安排相關在職教育、制定術後腰背酸痛監測指標、修訂術前護理指導單張及術後照護標準、拍攝術後照護光碟、挑選及購置翻身小枕頭及以ACT取代APTT監測病人凝血狀況等。經策略介入實施後，評值病人腰背酸痛發生率由100%降至13.15%，酸痛分數從7.6分降至4.9分，獲得顯著改善。

關鍵字

腰背痠痛 ； 冠狀動脈介入術 ； 護理

並列摘要

Many patients undergoing percutaneous coronary interventions (PCIs) via femoral access often complained of back pain. This project aimed to explore the reasons of back pain, develop solutions, and improve the quality of care. We collected data on patients who underwent PCIs via femoral access and found that the incidence of back pain was 100%, with a mean pain scores of 7.6±1.5. After analysis, the main causes were: the nurses were not taking the initiative in assessing and intervening the patients' back pain; no guidelines were available regarding postpercutaneous coronary intervention patients during bedridden period; lack of adequate positioning tool; and inefficient partial thromboplastin time (aPTT) testing. The following strategies were implemented: holding continuing training courses, developing monitoring indicators for postoperative back pain, revising preoperative nursing guidelines and postoperative nursing standard, filming postoperative nursing video, selecting and purchasing different shapes of pillows and using activated clotting time (ACT) as a substitute for aPTT test. After implementing these interventions, the incidence of back pain lowered from 100% to 13.15% and the mean pain scores dropped from 7.6 to 4.9, obtaining a significant improvement.

並列關鍵字

back pain ； nursing ； percutaneous coronary intervention (PCI)