- 期刊
降低腦損傷重症病人身體約束發生率
Reduce the Incidence of Physical Constraints in Critically Ill Patients with Brain Injury
摘要
腦損傷重症病人常有躁動、無法配合治療的表現，給予鎮靜劑，雖然可以改善躁動，但為了不影響神經學評估，只能低劑量使用，甚至是不用，導致身體約束發生率高出目標值，故希望藉由本專案來降低腦損傷重症病人身體約束發生率。經現況分析後，發現身體約束發生率高的主要原因：護理人員身體約束認知不足、缺乏科學化約束評估工具、替代式約束設備不足及擔心管路滑脫。以專案進行改善，擬定及執行以下策略：實施在職教育、運用約束決策輪盤、運用改良式手套、建立醫護團隊雙向溝通模式後，讓身體約束發生率由5.96%下降至2.97%，除達目標值外，專案使護理人員能夠有自信心，讓病人得到更人性化且高品質之照護，朝向無約束照護環境邁進。
並列摘要
Patients with severe brain injury are often agitated, which can be eased with sedatives. However, the use of sedatives should not affect the neurological assessment, with only low doses being administered, or none at all, which makes the physical limit higher than the target value. The incidence of data affecting physical limitations shows that caregivers have poor cognitive ability, lack of assessment and alternative tools, and fear of unplanned extubation. On April 1, 2017, we used on-the-job education, a restriction decision wheel, and a communication model and we improved the examination gloves for the medical team. This led to the incidence of physical limitations decreasing from 5.96% to 2.97%, more confident nursing staff, friendlier medical care, and a higher quality of care.
參考文獻
延伸閱讀
- 謝依真、林幼麗、駱佳宜（2021）。提升腦中風病人執行被動關節運動正確率。品質月刊，57(9)，14-22。https://www.airitilibrary.com/Article/Detail?DocID=10173692-202109-202110280006-202110280006-14-22
- 戴千淑、鄭朝惠、黃千恩、林少瑜、劉子菁、梁穎（2020）。提升腦中風病人急性後期照護下轉率。榮總護理，37(4)，360-368。https://doi.org/10.6142/VGHN.202012_37(4).0004
- 謝承樸（2009）。腦中風輔助高壓氧治療，有效改善後遺症。彰基院訊，26(3)，8-8。https://doi.org/10.29598/XLZY.200903.0003
- 戴國斌、蘇淑櫻、劉珮君、王怡婷、陳麗貞（2016）。Enhancing Transfer Safety of Critically Ill Patients in ED。長庚護理，27(3)，368-376。https://doi.org/10.3966/102673012016092703006
- Mei-Rong Weng、楊淑華（2016）。Multi-disciplinary rehabilitation for acquired brain injury in adults of working age。榮總護理，33(4)，434-436。https://doi.org/10.6142/VGHN.33.4.434