全髖關節置換術後衛教執行之改善方案

Improvement Program for Rehabilitation Education after Total Hip Replacement

趙瑩(Ying Chao) ； 蕭美麗(Mei-Li Hsiao) ； 石惠敏(Huei-Ming Shih) ； 陳克銘(Ke-Ming Chen) ； 莊國瑋(Kuo-Wei Chuang)

《北市醫學雜誌》 5卷6_S期 (2008/12) Pp. 692-700

https://doi.org/10.6200/TCMJ.2008.5.6.13

摘要

行全髖關節置換手術病患及早出院已成趨勢，為避免術後髖關節脫臼，肌肉無力，影響日常生活機能，護理人員提供復健及正確擺位的知識愈顯重要。本專案為某區域醫院骨科病房，筆者針對2006年1月至2007年2月術後衛教滿意度偏低之106位行全髖關節置換術患者，進行電話回溯性訪談52位，發現護理人員術後衛教執行率僅58%，經現況分析及問卷調查知衛教執行率低的原因有：護理人員復健衛教無標準流程、衛教內容不熟悉；衛教單張內容老舊、擺放不明顯；考核未落實。提出解決方案包括：制定標準化衛教流程、在職教育；重新設計THR視聽教材及規劃放置櫃；強化考核制度後，衛教能力提升，單張內容及取用方便性增加，衛教執行率由58%提升至92%，提供優質的護理服務。

關鍵字

全髖關節置換 ； 髖關節脫臼 ； 衛教執行率

並列摘要

This report intends to highlight the current trend of discharging patients from hospital as soon as they have received a total hip replacement. In order to avoid dislocation of the hip joint, strengthen weak muscles, and to allow patients to resume normal daily activities, it is essential that nursing staff provide patients with sufficient knowledge for rehabilitation and correct body posturing. This project took place in an orthopedic ward of a regional hospital where the researcher surveyed 106 patients who had had total hip replacement surgery between January 2006 and February 2007. All of the patients had experienced poor satisfaction during their rehabilitation process. Telephone interviews were conducted on 52 patients, and found that the post-surgical rehabilitation education administration rate by nursing staff was only 58%. Through data analysis and questionnaires, the reasons for these low administration rates for rehabilitation education were found to be: a general lack of a standardized procedure for providing rehabilitation education, unfamiliarity by staff with the actual material needed to be taught to the patient; outdated materials; poor display position for the educational material used by the patients; an inefficient review process that would enable a better self-monitoring of patient satisfaction. The proposed solutions included: standardization of the rehabilitation education procedure; on-the-job training for nursing staff; updating educational materials; redesigning and repositioning the display shelf. After reinforcing the review system, the educational competency was improved, and informational brochures were obtained more easily by the patient, thus the administration rate of rehabilitation education was increased from 58% to 92% to offer a superior nursing service.

並列關鍵字

total hip replacement ； dislocation of hip joint ； rehabilitation administration rate