- 期刊
提升醫療團隊對手術全期照護之完整率
Enhance the Medical Team of Perioperative Care of the Full Rate
摘要
手術全期照護的完整性不足一直是台灣醫療院所普遍存在的問題，其發生的原因大多是起因於在台灣現行的健保醫療制度下，醫護人員的工作量超乎一般的工作者，以致相關從業人員的總量短缺，其護理人員素質亦不如以往，因而無法應付現今台灣病患的手術醫療需求，進而導致醫師、護理人員、病患以及病患家屬等四方在手術全期溝通上有著明顯認知上的落差。本研究的目的在探討醫療團隊對手術全期照護的行為趨向、知識與態度，採取橫斷式之相關性研究。本文以北部某地區醫院醫護人員為樣本，研究工具為自擬之行為趨向、知識與態度問卷，共收集32台刀的手術全期照護查檢表，計有192人次的醫護人員參與，問卷內容以SPSS 17.0軟體進行分析與檢定。結果顯示：行為趨向以『術後護理措施』的分數最高，『於手術後追蹤病患狀況與和病患及家屬的溝通』的分數則是最低；手術全期照護知識則是以『術後護理措施』的落點得分最高，『手術前後期與病患溝通』的得分則是最低；手術全期照護的態度則是普遍趨於正向；護理進階職級、照護手術全期病患經驗的頻率以及是否有接受相關照護課程訓練，在手術全期照護知識的落點得分上有著顯著性的差異；是否能在手術全期內各階段有效的做好該交辦事項以及接受相關照護課程訓練，與行為趨向的落點得分答達顯著性的差異；手術全期的照護態度與行為趨向則是呈正向關係。依照本研究結果建議手術醫療團隊的護理養成教育應將手術前後與病患家屬以及病患本身的溝通納入實習課程考核，並且制定手術中後期的臨床照護指引、規劃手術醫護人員的在職教育訓練、並安排護理人員之間的經驗傳承與交叉訓練，以提升醫療團隊在手術全期照護的完整率。
並列摘要
Perioperative care of the integrity lacking at medical institutions that has been a common problem and it was mostly occurrence in Taiwan. Medical staff workload is more than general practitioners and the relevant total employees is short, Its caused due to the current health insurance system. The quality of nursing staff is not good as before and it can not cope with today's medical require of surgical patients in Taiwan. So it would lead to physicians, nurses, patients and families in the perioperative communication that has a significant to confusion. This study aims that is contain that the investigation the medical team caring for the perioperative behavior trends, knowledge and attitudes related to cross-sectional. In this article, the sample of hospital staff was in north area at Taiwan, the research tools were include that the knowledge and attitude questionnaires were collected 32 knives and 192 people participate perioperative care checklist. The medical staff involved in the questionnaire to SPSS 17.0 software for analysis and verification. The results showed as below : For the acts trend ; ”Post-operative care measures”, it got the highest scores ; ”In the post-operative status, tracking patient communication and patients and their families ”, the score was the lowest ; For perioperative care knowledge ”After care measures ; ” it got highest score ; ” To communicate with the patient before surgery later ” , the score is the lowest ; Perioperative care in general trend is a positive attitude ; The care advanced rank, perioperative patient care experience and whether the frequency of care-related courses to receive training in perioperative care knowledge that had a significant impact point score difference; Whether the whole period in the various stages of surgery to do the effective action items relating care and to receive training courses. The placement and behavior that tend to score of significant differences; Perioperative care attitude and behavior of the trend were a positive relation. Accordance with the results of this study suggest that had to surgery to develop education and health care team should be patient with the patient's family and practice their communication before and after surgery. It needed to put into the curriculum assessment and development of surgery in the latter part of clinical care was guidelines for planning surgical staff in-service education and training. We could have been arrangements between nurses learning of experience and cross-training to enhance the medical team in the perioperative care of the full rate.