- 期刊
降低口腔癌手術病人鼻翼皮膚損傷發生率
Reduction of the Incidence of Nasal Ala Skin Lesion on Oral Cancer Patients Undergoing Surgery
摘要
壓瘡是長時間手術病人可能發生問題之一，維持皮膚完整性是護理人員的重要職責。本手術室口腔外科2008年口腔癌重建手術，術後產生鼻翼壓瘡皮膚損傷者有8人，經回溯病歷資料及調查發現因長時間手術，麻醉之氣管內管固定滑脫無保護措施而導致鼻翼皮膚出現損傷；故本專案之目的在尋求有效之護理措施以降低口腔癌重建手術後鼻翼皮膚缺損之發生率。經成立專案小組，建立並實施鼻彎氣管內管保護及固定照護標準、在職教育、定期執行監測等措施後，口腔癌病患之鼻翼皮膚損傷發生率由專案前3例／季（38.5%）降為1例／季（11.1%）。可證明專案小組早期評估並尋求解決改善方法，確可保護病人免於發生鼻翼皮膚損傷的發生，並促進手術照護品質。
並列摘要
Pressure sore is one of the problems in patients who underwent a long duration of surgery. For nursing staff at operative room, it is important to prevent skin lesions for those who receive such surgeries. At our OR, there were eight skin lesions over nasal ala detected postoperatively in patients who received reconstructive surgery due to oral cancer in 2008. After retrospective chart review and investigation, endotracheal tube displacement without any protective prevention was the main reason causing such lesions after long-duration surgery. The study aimed to find effective nursing measures out to reduce the incidence of nasal ala skin lesion after oral reconstructive surgery. By establishing the standard procedures for fixation and protective method of nasotracheal intubation, education, and regular monitoring, the trimestral incidence of nasal ala skin lesion reduced from 38.5% to 11.1%. The result approved that early assessment and establishment of protective procedures can prevent patients from such skin lesions and improve intraoperative nursing quality.