建置護理人員「異體手」捐贈摘取手術準備流程之專案

Developing Surgical Preparation Procedures for Nurses to Extract a Donated ＂Allogeneic Hand＂

馬怡令(Yi-Ling Ma) ； 王琦(Chi Wang) ； 林秋子(Chiu-Tzu Lin) ； 邱雅婷(Ya-Ting Chiu) ； 戴秋玉(Chiu-Yu Dai) ； 賀倫惠(Lun-Hui Ho)

《志為護理-慈濟護理雜誌》 20卷1期 (2021/02) Pp. 83-97

摘要

異體手移植在移植醫學上是一大躍進，為複雜性高新的手術法，其捐贈手摘取是影響病人移植手術的重要指標，經現況分析發現人員對異體手捐贈摘取手術執行及認知正確性低。原因為（一）不知捐贈手臂包覆保冰保存方法（二）無捐贈手臂保存置放容器（三）不知捐贈病人手臂修復。擬定改善方案：舉辦捐贈手臂摘取教育訓練及工作坊、建構捐贈手臂摘取手術標準流程、增購捐贈手臂置手桶、特製修復手臂美觀手。專案實施後，人員摘取手術執行正確性由50.3％提升99.6％；摘取手術認知正確性提升到99.1％。顯示本專案具體可行，可提升異體捐贈摘取手術病人安全及醫療品質。

關鍵字

手術準備 ； 異體手捐贈 ； 標準作業

並列摘要

Allogeneic hand transplantation, a highly complex new surgical procedure, constitutes a major advancement in transplantation medicine. The preparation for the extraction of a donated hand is a critical indicator affecting patients' transplant surgery. This study revealed that the accuracy of surgical personnel's execution and their understanding of the extraction surgical procedure of the allogeneic hand was low. The causes included the following: 1) having limited knowledge of the storage method for a donated hand on ice, 2) lacking a container for storing and placing a donated hand, 3) and having limited knowledge of the repair surgery of a patient undergoing transplantation. The proposed improvement plan included conducting training and workshops on donated hand extraction, developing standard surgical procedures, purchasing containers for placing donated hands, and customizing prosthetic hands. After the improvement plan was implemented, the accuracy of the extraction procedure of surgical personnel increased from 50.3% to 99.6% and that of knowledge of extraction surgery increased to 99.1%. This indicates the value of this project in improving patient safety and medical quality associated with allogeneic donation extraction surgery.

並列關鍵字

allogeneic hand donation ； standard operating procedures ； surgical preparation

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