血液透析病人的外籍看護之防疫管理

Infection Prevention of Foreign Caregivers in Hemodialysis unit

林小閔(Shiau-Min Lin) ； 陳碧蓉(Pi-Jung Chen) ； 黃綉雲(Hsiu-Yun Huang) ； 李佳蓉(Jia-Jung Lee)

《北市醫學雜誌》 20卷2期 (2023/06) Pp. 161-168

https://doi.org/10.6200/TCMJ.202306_20(2).0001

摘要

2020年2月26日公佈首例外籍看護確診新冠肺炎（COVID-19），引起醫療機構巨大衝擊及意識到此議題的重要性。又血液透析之病人以高齡者居多，他們大多仰賴外籍看護的照護陪伴占70%，因此在面對新冠肺炎的侵襲時，將外籍看護納入防疫管理的對象，益顯重要。團隊運用改變－安全－灌輸（Change-Safe-Instill; CSI）之概念，改善外籍看護的過去行為及日常作息，以知識灌輸學習來增加技能；且以I AM BEST口號強化知識灌輸，高規格的安全防護措施包括盤點造冊（Inventory）、陪伴（Accompany）、口罩（Mask）、建立分流（Build Shunt）、教育訓練（Education）、社交距離（Social distance）以及團隊照護（Team care）。以協助外籍看護了解防疫重點，使其得與異鄉家人及其他外籍看護分享正確訊息，成為國內外防疫工作的重要夥伴。

關鍵字

血液透析 ； 新冠肺炎（COVID-19） ； 防疫作為 ； 外籍看護

並列摘要

The novel coronavirus pneumonia (COVID-19) has spread to the whole world. The first confirmed COVID-19 case in foreign caregivers was announced on February 26, 2020, bringing colossal impacts to the medical institutions and raising insights into the importance of this issue. The patients with hemodialysis in our unit are primarily elderly, and most of them rely on foreign caregivers for daily care and accompany. Up to 70% of the caregivers of our dialysis unit were foreign caregivers. Thus, it is crucial to include foreign caregivers in the pandemic prevention population when confronting the attacks of COVID-19. Considering the gathering during holidays and differences in living habits differences of the caregivers, we set up the infection prevention norms, allowing only one person to access the dialysis unit with the patient, wearing a mask throughout visiting process, implementing hand hygiene, respiratory hygiene and cough etiquette, and prohibiting the home isolation and home quarantine persons from accompanying or visiting the patients. We used the CSI (Change; Safe; Instill) concept to enhance the daily routines and knowledge of the foreign caregivers. The team invented high-standard safety protection measures named I AM BEST: (1) Inventory, (2) Accompany, (3) Mask, (4) Build Shunt, (5) Education, (6) Social distance, and (7) Team care. Based on I AM BEST, the foreign caregivers were empowered by the specific COVID-19 health education and shared the knowledge or information with their families at the foreign land and other foreign caregivers, and eventually, become essential allies for infection control in this and other countries.

並列關鍵字

hemodialysis ； COVID-19 ； infection prevention ； foreign caregiver

參考文獻

吳婷婷，曾麗荷，陳淑美，洪正隆。護理指 導衛教資訊管理系統應用品質管理循環之成 效探討。榮總護理2019；36(1)：62-71。

蘇秋霞，羅一鈞，石崇良等。臺灣COVID-19 醫療照護體系整備與應變措施。疫情報導 2020；36(16)：251-258。

簡鴻宇，徐永勳，江建昌等。COVID-19 全 球流行時的契機：醫療之轉變與創新。北市 醫學雜誌2020；18(1)：1-9。

黃安琦，張佳琪，劉芳，陳柏安，郭淑芬。 探討外籍看護對失能老人照顧知識、態度與 行為之相關因素。新臺北護理期刊2020； 22(2)：33-43。

徐永勳，陳芳琪，林翠娟，蕭勝煌。透析中 心因應COVID-19 的防疫變革。北市醫學雜 誌2021；18(1)：10-19。