加護病房護理師對連續性腦波監測儀操作及照護改善專案

Continuous Electroencephalography Management and Improvement Project for Nurses in an Intensive Care Unit

蔡蕙如(Hui-Zu Tsai) ； 吳佳玲(Jia-Ling Wu) ； 蔡鈴琴(Ling-Chin Tsai)

《志為護理-慈濟護理雜誌》 18卷3期 (2019/06) Pp. 91-102

摘要

本單位使用連續性腦波監測儀監測腦損傷重症病人腦波變化，需要仰賴護理師密切觀察腦波形變化及確保電極線路位置正確，方能提供腦波變化之正確訊息。經調查發現，護理師對連續性腦波監測儀認知不足、操作程序不熟悉、不了解照護重點、不會判讀腦波形及未舉辦教育課程。經專案小組舉辦在職教育、錄製課程影片、制定操作指導手冊、操作及照護標準、腦波圖卡、操作及照護正確率監測計畫，使護理師對連續性腦波監測儀認知由38.8%提升至96.4%，操作及照護正確率由28.6%提升至95.8%，期盼藉由本改善專案推行，能充實護理師知識與技能，提升對神經外科重症病人的評估及照護能力。

關鍵字

神經外科 ； 加護病房 ； 連續性腦波監測儀

並列摘要

In our intensive care unit (ICU), we use continuous electroencephalography (CEEG) to monitor changes in brain activity in patients with severe traumatic brain injury. Thus, our ICU nursing staff must be able to monitor EEG waveform changes and confirm the electrode position. After conducting a survey, we discovered that our nursing staff lacked knowledge regarding EEG monitoring, were unfamiliar with operating procedures, were unaware of the purpose of CEEG, were unable to interpret EEG waveform changes, and had not undergone educational courses regarding CEEG. After our project team launched educational training by providing CEEG operating manuals and videos and developing an CEEG standardized operating procedure, EEG waveform flashcard, and correct EEG operating plan, our nursing staff's awareness regarding CEEG increased from 38.8% to 96.4% and the correct operating rate increased from 28.6% to 95.8%. We hope that through this project, we can broaden the skills and knowledge of our nursing staff and enhance the evaluation and caring ability of our nurses in critical neurosurgery.

並列關鍵字

continuous electroencephalography ； intensive care unit ； neurosurgery

參考文獻

吳金玲、林怡秀、黃小萍、徐玲蕙、徐旭香(2012)．兒科加護病房病人放置葉克膜護理流程完整性之改善方案．護理雜誌，59(6)，65-72。doi:10.6224/JN.59.6.65

胡寶雪、胡曉珍、黃惠如、趙慧玲、雷宜芳(2014)．運用失效模式與效應分析改善手術室病理檢體採集送檢流程及退件率．護理雜誌，61(2)，50-59。doi:10.6224/JN.61.2S.50

翁慧娟、陳雪華、謝寶煖(2016)．護理資訊素養課程規劃與實施成效之研究．教育資料與圖書館學，53 (6)，139-170。doi:10.6120/JoEMLS.2016.532/0003.RS.CM

陳宜貞、鄭瓊琪、龔瑞琛、王荔雲、蔡忠榮、許端容(2012)．一頭部外傷病患使用低體溫治療之呼吸照護經驗．呼吸治療，11(1)，37-43。doi:10.6269/JRT.2012.11.1.04

黃雅玉、陳怡任、藍仁鴻、廖宗義、阮國榮、黃英彥(2016)．運用品質管理循環縮短姑息性緊急放射治療之等候時間．放射治療與腫瘤學，23 (4)，259-268。DOI：10.6316/TRO/201623(4)259