提升腦中風病人全關節運動之護理計畫

A Nursing Program in Improving Joints' Range of Motion among Stroke Patients

郭惠慈(Hui-Tzu Kuo) ； 朱以婷(Yi-Ting Chu) ； 洪芳禎(Fang-Chen Hung)

《北市醫學雜誌》 6卷1期 (2009/02) Pp. 45-58

https://doi.org/10.6200/TCMJ.2009.6.1.05

摘要

腦中風病人佔全病房30%，儘早執行全關節運動，可預防關節攣縮及協助恢復最大活動能力。2007年5月針對中風病人主要照顧者使用「護理人員給予中風病人主要照顧者全關節運動護理指導之查核表」進行為期一個月的調查，發現護理人員給予全關節運動護理指導執行率僅有53%，主要原因有全關節運動護理指導內容認知不足、缺乏護理指導標準及護理指導紀錄表；經由舉辦護理人員教育訓練、制定全關節運動護理標準、製作全關節運動護理指導手冊和護理指導紀錄表等改善方案；促使護理指導執行率由53%提昇至96.4%，成效顯著。本專案強化護理人員認知、落實護理指導，期望將全關節運動護理指導推廣到其他單位，讓亦有肢體功能障礙之病人受惠，提供高品質護理。

關鍵字

全關節運動 ； 護理指導 ； 主要照顧者

並列摘要

We report on a study based on the early treatment of post-cerebral vascular accident (CVA) patients with a range of motion (ROM) rehabilitation program. The aim of this early intervention was to encourage the full recovery of joint activity in our patients. This investigation focused on the findings of our key caregiver for post-CVA patients and the implementation efficiency levels of nursing education in the ROM rehabilitation program. This occurred over the month of May in 2007. The results of this showed an implementation efficiency of only 53%. The main causes of poor implementation were divided into three categories: a general lack of nursing knowledge, a lack of standard operating procedures (SOP) and poor evidence-based nursing skills. To address this situation, a target team was built to restructure staff training, develop an SOP instruction manual for the ROM rehabilitation program, and to emphasize the importance of making clear, accurate patient records. By doing this, the implementation efficiency of nursing education in ROM rehabilitation program was enhanced from 53% to 96.4%. The project was able to not only strengthen the ability of nurses so that they could become educators for post-CVA patients but also encourage them to promote ROM rehabilitation programs in other units. Through these actions we are now able to achieve a much higher quality of nursing for CVA patients.

並列關鍵字

ROM rehabilitation program ； CVA patients ； caregiver ； early intervention