一位人工髖關節置換術病人接受多次清創手術之護理經驗

Nursing Care Experience of a Patient Undergoing Multiple Debridement Procedures after Artificial Hip Joint Replacement Surgery

陳鈺潔(Yu-Chien Chen) ； 林心怡(Hsin-Yi Lin)

《馬偕護理雜誌》 13卷2期 (2019/07) Pp. 41-51

https://doi.org/10.29415/JMKN.201907_13(2).0004

摘要

本文旨在探討照顧一位接受全人工髖關節置換術，因知識缺失導致傷口癒合不佳，入院接受多次清創手術之個案護理經驗。護理期間自2016年6月27日至7月15日，筆者運用Gordon十一項健康功能型態評估，藉由病史收集、病歷查閱、會談、觀察等方式蒐集資料，確認問題為疼痛、潛在危險性感染、知識缺失。照護過程中，評估個案的需求，針對問題設計具個別化的護理活動，以觀看歌仔戲及深呼吸技巧來轉移疼痛注意力；給予適當的傷口照護，教導營養食物的攝取，避免傷口感染；運用SRRS（簡化－重複－更新－簡化）教學活動理論設計活動，採漸進式教學，指導復健活動並固定時段練習，又利用自製傷口模型教導傷口換藥，透過重複操作學習，適時給予正向鼓勵，以增加自我照護能力，更也讓筆者在照護過程中與個案相互成長，透過此次護理經驗的分享，提供護理人員照護相關個案的參考。

關鍵字

人工髖關節置換術 ； 清創 ； 知識缺失

並列摘要

The main purpose of this study is to explore the nursing care experience of a patient who has undergone multiple debridement procedures after his total hip joint replacement surgery due to a lack of proper would knowledge during his hospitalization. During the nursing period from June 27 to July 15, 2016, observation, conversation and physical assessment skills were used to follow Gordon's 11 multi-functional health scales to gather information and assess the case for health problems, including pain, potential infection risks, and lack of would related knowledge. process, individualized nursing activities were designed, guided by the SRRS (Simplify-Repeat-Renew-Simplify) teaching activity theory, to accommodate patient needs. Creative interventions, such as watching Taiwanese (folk) Ke-Tse opera and practicing deep breathing techniques to distract the patient from pain, providing information about adequate wound care, and facilitating wound healing by supplementing nutrients were encouraged to control further infections. The outcome was promising that the patient's self-care ability has increased through positive encouragement. This nursing experience would shed some light to health care providers when caring for post-operation patients with multiple would infections requiring would debridement surgeries.

並列關鍵字

Wound Infection ； Artificial Hip Joint Replacement Surgery