本專案為提升消化道出血病人疾病認知正確率。消化道出血屬於內科急症,若病人對消化道出血疾病認知不足易延誤就醫,增加住院天數、家屬照護負擔及醫療費用的支出。若住院期間,有完整的護理指導,有助於增強病人及家屬對消化道出血疾病的認知,提升病人返家自我照顧能力。經調查消化道出血病人疾病認知正確率低的原因:教材不夠豐富、病人不知道什麼原因會導致出血、無規範消化道出血衛教流程及稽核制度。進行改善策略:新增下消化道出血衛教單張、製作上、下消化道出血衛教海報、“便"識色卡、“便"識模型、增加消化道出血團體衛教場次、制定消化道出血衛教標準流程及稽核制度。專案推行後結果發現:消化道出血病人疾病認知正確率由74.67%提升至96.33%;病人對消化道出血護理指導滿意度由67.33%提升至95.33%,顯示專案介入措施效果有成效。建議以健康識能友善素材,製作清晰易讀、易理解的消化道出血衛教手冊,除了讓病人及家屬可在醫院翻閱外,並可加入QR CODE,以提供病人出院後返家之參考。
The aim of the project was to improve the correct rate of disease cognition among patients with gastrointestinal bleeding. Gastrointestinal bleeding is recognized as a medical emergency condition and lack of disease cognition may result in delay of medical care, prolonged length of stay, increasing the care burden and medical expenditures. Instead, a comprehensive nursing instruction could have benefit in enhancing disease cognition and self-care ability among patients and family. According to the authors investigation, the reasons contributing to low correct rate of disease cognition among patients with gastrointestinal bleeding are as follows: insufficient educational materials, poor level of knowledge regarding gastrointestinal bleeding, and a lack of standard operating procedures and audit for health instruction. The strategies implemented to solve the problems included: producing health pamphlets and poster of upper and lower gastrointestinal bleeding, stool identification cards, stool identification models, increasing education sessions of gastrointestinal bleeding, and development of standard operating procedures and audit system for health instruction for gastrointestinal bleeding. After implementation of the project, the correct rate of disease cognition increased from 74.67% to 96.33%, and the level of satisfaction toward nursing unstruction increased from 67.33% to 95.33% among patients with gastrointestinal bleeding. It is suggested to produce a clear, readable, and understandable health education manual for gastrointestinal hemorrhage based on the principles of health literacy-friendly materials. Health education manual with QR code can also provide an opportunity for patients and family to read in hospitals and home.