一位初產婦面臨新生兒死亡及術後傷口感染之照護經驗

本文描述一位初產婦術後傷口感染住院，且面臨新生兒出生後死亡，正值哀傷期之初產婦住院照護經驗，住院期間自2012年2月25日至2012年3月3日，筆者以實際觀察、深入會談、傾聽及身體評估方式收集個案相關資料，並運用羅氏適應模式進行護理評估，發現個案有：高危險性感染、哀傷及焦慮等護理問題。筆者經由護理過程，密切觀察傷口變化及生命徵象監測，配合傷口護理及抗生素治療，以達預防傷口惡化，並促進傷口癒合，個案住院期間因失去新生兒感到哀傷，而無法入睡，筆者不斷與個案溝通，引導個案說出失去新生兒失落及內心感受，並肯定在懷孕過程中，個案對新生兒的付出，減輕自責，協助個案接受寶寶死亡的事實，走出失去新生兒的陰霾，希望藉此護理經驗，提供護理人員在照護此類個案之參考，以發揮護理專業功能。

關鍵字

周產期失落；新生兒死亡；傷口感染

並列摘要

This case study described the nursing care experience of a woman who faced with baby's death during the primipara postoperation wound infections in hospital. This primiparra inpatient was cared from 25 Feb. to 3 Mar. in the year of 2012. During the nursing period, the author applied the skills of observation, conversation, listening, and physical assessment to collect relative data. Roy's adaptation model was also applied to assess and improve the care quality. High risk of infection, grieving, and anxiety problems were identified from this patient. Wound infection and vital signs were closely observed. Wound care and antibiotic treatment were provided to prevent deterioration and help the healing of wound. Depression and insomnia cased from the loss of baby of this woman was improved by personal conversations. Empathy and mental supports were providing to relieve patients guilty for the baby's death. This special nursing experience can provide a practical example for the nurse to care complex cases and promote the function of nursing care.