提升加護病房護理師執行經口留置氣管內管病人口腔清潔之成效

Effectiveness of Performing Oral Hygiene by ICU Nurses for Orally Intubated Critically Ill Patients

黃麗娟(Li-Chuan Huang) ； 李珍珍(Chen-Chen Lee) ； 梁子翎(Tzu-Ling Liang) ； 楊于瑩(Yuh-Ying Yung) ； 倪正怡(Cheng-Yi Ni)

《馬偕護理雜誌》 9卷1期 (2015/01) Pp. 19-30

https://doi.org/10.29415/JMKN.201501_9(1).0002

摘要

加護病房護理師協助經口留置氣管內管病人維持口腔清潔是每日必要的護理工作，但臨床上卻發現執行後仍會有不潔淨或異味的問題，本專案旨在提升護理師執行經口留置氣管內管病人口腔清潔成效，專案自2013年6月1日至11月15日止，經由現況分析確認因：1.使用清潔工具效果不彰、2.護理師清潔部位不完整、3.相關技術標準及常規不足，導致護理師執行經口留置氣管內管病人口腔清潔成效不佳。確認改善方案為改良口腔清潔工具、訂定口腔清潔步驟及修定常規，以課室及臨床帶教方式進行宣導及實務推動。經本專案改善後，護理師在執行口腔清潔部位完整性由47.6%提升至100%，口腔清潔後成效於牙菌斑指數評價由專案前的3至5級改善為0至2級，已達到本專案改善目的並提昇口腔照護品質。

關鍵字

口腔清潔 ； 經口留置氣管內管病人 ； 加護病房

並列摘要

Maintaining the oral hygiene of orally intubated critically ill patients is fundamental works of ICU nurses. However, there is still the problem of unclearness or odor after performing the oral hygiene. This project aimed to enhance the effectiveness of oral hygiene, and the period was from June 1 to November 15, 2013. The risk factors included 1) the cleaning tools were not hygienic enough; 2) the nurses didn’t clean the entire oral cavity; and 3) the information of clinical skills, procedures and regulations were insufficient. The altered strategies referred to improving the hygiene of cleaning tools; establishing the oral hygiene procedures and regulations; and implementing and practicing in the classroom and bedside teaching. Through this project, the effectiveness of carrying out oral hygiene in patients increased from 47.6% to 100%. The plaque index before the project was 3 to 5 degree, and it was upgraded to 0 to 2 after the project. The aim of this project has achieved and the quality of oral care has improved.

並列關鍵字

oral hygiene ； orally intubated critically ill patients ； intensive care unit