導入「3D列印恥骨上聯合膀胱造廔模具」－提升居家尿管留置異常評估與處置之成效初探

Preliminary exploration of the effectiveness of introducing ＂3D-printed models for suprapubic cystotomy＂ in promoting the assessment and management of anomalous retention of urinary catheters at home

陳乃菁(Nai-Ching Chen) ； 許瑞津(Jui-Chin Hsu) ； 盧怡利(I-Li Lu) ； 翁瑞侑(Jui-Yu Weng) ； 郭進榮(Jinn-Rung Kuo)

《台灣擬真醫學教育期刊》 7卷1期 (2020/06) Pp. 4-13

https://doi.org/10.6582/JTSSH.202006_7(1).0001

摘要

背景與目的：恥骨上尿管是居家護理團隊照護常見且具潛在風險的醫療裝置，如何正確、安全執行恥骨上尿管置換與照護，是居家護理師與醫師基本且重要的專業能力。本研究運用翻轉教學暨3D列印恥骨上聯合膀胱造廔模具與擬真情境教學法指導居家護理師，評量學員面臨恥骨上尿管錯置異常事件之評估、處置及團隊支援與溝通，探討此教學模式之成效。研究方法：本研究採單組前後測類實驗設計，收案期間為2019年10至12月居家護理所之居家護理師（n=12），導入「恥骨上尿管錯置異常事件評估與處置」擬真教學，比較恥骨上尿管錯置異常事件評估與處置之知（技）能之差異及能力自信程度。研究結果：導入此教案之學習成效，知能前後測平均得分分別為79.17（±10.62）分與97.08（±3.96）分，呈現顯著差異（p=.002），技能前後測平均得分分別為18.5（±2.58）分與25.33（±2.15）分，呈現顯著差異（p=.002），學員自評與教師評值學員的自信程度均為「很有自信」。結論:運用擬真情境及客觀結構式臨床技能測驗（Objective Structured Clinical Examination；以下簡稱OSCE）測驗可執行多元評量，增加居家護理師對於恥骨上尿管錯置異常事件評估的處置能力。

關鍵字

恥骨上尿管錯置異常 ； 客觀結構式臨床技能測驗 ； 翻轉教學 ； 擬真情境教學 ； 3D列印 ； 恥骨上聯合膀胱造廔模具 ； 居家護理師

並列摘要

Background and Purpose: The suprapubic catheter is a common and potentially risky medical device for home care nursing teams to care for. The ability to properly and safely perform suprapubic catheter replacement and care for the patient is a fundamental and important professional skill for home health care nurses and physicians. The present study explores the effectiveness of utilizing the flipped teaching method, the 3D-printed models for suprapubic cystotomy, and a simulation-based approach in teaching home care workers how to assess and manage the problem of misplaced suprapubic urinary catheters, as well as to provide team support and communication. Research Methods: The present study adopted a one-group pretest-posttest quasi-experimental design. Home care nurses (n=12) in a home care setting were enrolled from October to December 2019. After the introduction of the ＂ Assessment and management of anomalous retention of urinary catheters＂ simulated teaching, the differences in knowledge (skill) and the confidence level in the ability to assess and manage abnormal events of suprapubic catheter misplacement were compared. Results: As for the learning effectiveness following the introduction of this lesson plan, the mean scores of the knowledge in the pre and post-tests were 79.17(±10.62) and 97.08(±3.96) respectively, which showed significant differences (p=.002), and the mean scores of the skill in the pre and post-tests were 18.5(±2.58) and 25.33(±2.15) respectively, which showed significant differences(p=.002). The confidence level of the students in both self-assessment and teacher assessment was ＂very confident＂. Conclusion: The use of scenario-based teaching and Objective Structured Clinical Examination (OSCE) allows diversified assessments to be performed and increases the ability of home care nurses to assess and manage the anomalies of suprapubic catheter misplacement.

並列關鍵字

Suprapubic Catheter Misplacement ； Objective Structured Clinical Examination ； Flipped Teaching ； Simulation-Based Teaching ； 3D Printing ； Suprapubic Cystotomy Model ； Home Care Nurse