跨領域團隊組合式照護於提升髖關節置換術後病人早期下床復健之成效

The Effect of Interprofessional Collaborative Practice to Facilitate Early Mobilization among Hip Replacement Patients

鄭君婷(Chun-Ting Cheng) ； 李怡珍(Yi-Chen Lee) ； 柯雅婷(Ya-Ting Ke) ； 郭嘉琪(Chia-Chi Kuo)

《馬偕護理雜誌》 17卷1期 (2023/01) Pp. 16-28

https://doi.org/10.29415/JMKN.202301_17(1).0002

摘要

髖關節置換術後病人早期下床復健，可提升日常生活活動功能與縮短住院天數。本專案旨在以實證手法導入跨領域團隊組合式照護模式，探討髖關節置換術後早期下床復健之介入成效。第一階段成立跨領域專案團隊，分析病人術後延遲下床率高的原因。第二階段擬定改善方案為：一、制定早期下床復健組合式照護標準；二、重新設計早期下床復健運動課程及學習營；三、制定資訊化照會細則；四、修訂衛教單；五、製作復健運動影片；六、制定資訊化交班規範。結果顯示專案介入後，延遲下床率由72.09%下降至2.01%（p< .0001），日常生活活動功能總分由36.16分提升至79.22分（p< .0001），病人住院天數由6.53天縮短至5.31天（p< .0001），護理人員早期下床復健之照護知能正確率由73.92%提升至95.82%。跨領域團隊組合式照護導入臨床進行實證知識轉譯，可有效提升護理照護能力，改善髖關節置換術後病人之延遲下床率、提升日常生活活動功能與縮短住院天數，將有助於照護品質提升與減少醫療資源浪費。

關鍵字

跨領域團隊 ； 組合式照護 ； 髖關節置換 ； 早期下床復健

並列摘要

Facilitating early mobilization of patients after hip replacement not only has great potential to improve activities of daily living (ADL) but also shortens the length of hospital stay. This evidence-based project aims to introduce the bundle care model of interprofessional collaborative practice (ICP), and explore the effect of early mobilization among hip replacement patients. In the first stage, a task-oriented team was established to facilitate interprofessional collaboration to analyze the high rate of delayed mobilization after hip replacement surgery. In the second stage, an improvement plan was developed to: 1) formulate the standard of procedures related to early mobilization according to the bundle care model; 2) redesign the rehabilitation exercise in learning camps to facilitate early mobilization; 3) set up an informatics referral system; 4) modify current health education materials; 5) create rehabilitation exercise videos; and 6) design an electronic medical record system for nursing handovers. Upon completion of the project, the rate of delayed mobilization has decreased from 72.09% to 2.01% (p< .0001). The total scores for ADL also have increased from 36.16 to 79.22 (p< .0001), while the length of hospital stay reduced from 6.53 to 5.31 days (p< .0001) with an increased accuracy rate of nursing care knowledge of early mobilization from 73.92% to 95.82%. The utilization of a bundle care model to implement interprofessional collaborative practice has shown effectiveness for patients after hip replacement, leading to quality care without excessive medical costs.

並列關鍵字

interprofessional collaborative ； bundle care ； hip replacement ； rehabilitation of early mobilization