提升冠狀動脈疾病病人對使用舌下硝酸含錠之正確率

舌下硝酸含錠是立即緩解冠狀動脈疾病病人胸痛，避免造成心肌缺氧之藥物，然經探查心臟內科加護病房47位非初次罹患冠狀動脈疾病病人使用舌下硝酸含錠的正確率僅為14.89%。為提升使用舌下硝酸含錠之正確性，介入性策略為：藉由舉辦主題討論會，釐清加護病房人員執行藥物指導的意義，製作多元化指導輔具，進而依病人個別性選擇合適的指導方法及教具，並將指導狀況納入品管監測中。實施成果，不僅正確率提升至95%以上，也改善口頭執行時內容不完整的問題。建議將使用舌下硝酸含錠指導標準化，推展使用各項指導輔助教材，並建立個案管理制度，持續追蹤病人返家後服用藥物狀況，以提高其因應疾病能力。

關鍵字

冠狀動脈疾病；舌下硝酸含錠；心臟內科加護病房

並列摘要

Sublingual Nitroglycerin (SLNTG) is administered to patients with coronary artery disease (CAD) to provide immediate chest pain relief and to avoid myocardial ischemia. A retrospective analysis of 47 patients in cardiac care unit with recurrent CAD, however, revealed that only 14.89% knew how to take SLNTG appropriately. The aim of the proposal was to improve the accuracy of administering SLNTG for patients, and the following interventions were introduced: hold educational seminars to clarify the significance of medication instructions by ICU nurses, design diversified instruction aids, select appropriate instruction methods and aids tailored to individual patient's needs, and place the conditions of instruction under quality control monitoring. After the project was done, the accuracy of taking SLNTG in patients with CAD increased from 14.89% to 95% and the issue with incomplete verbal content was improved. These strategies are applicable to nurses not only provides more systematically instruction, but also clarify the concept of great timing to implement SLNTG instruction. Therefore, it is suggested to standardize SLNTG nursing instruction, popularizing various instruction aids, establishing a case management system to counsel the process of taking SLNTG, and provide follow-up care to discharged patients to enhance self-management and disease coping.

並列關鍵字

cardiac care unit ； coronary artery disease ； sublingual nitroglycerin

國際替代計量

提升冠狀動脈疾病病人對使用舌下硝酸含錠之正確率

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