提昇護理人員對術後腸造口照護之完整性

Increasing the Completeness of Postoperative Colostomy Care

曾淑榆(Su-Yu Tseng) ； 謝雅婷(Ya-Ting Hsieh) ； 王晶瑩(Jing-Ying Wang) ； 林秀如(Hsiu-Ju Lin) ； 沈永釗(Yung-Chao Shen) ； 簡麗瑜(Li-Yu Chien)

《長庚科技學刊》 19期 (2013/12) Pp. 137-149

https://doi.org/10.6192/CGUST.2013.12.19.12

摘要

手術後提供完整的腸造口照護，有助於腸造口的皮膚完整性及合併症的預防，現行有許多醫療機構都設有專責單位來執行腸造口照護，病房護理人員若過於仰賴專責單位執行腸造口照護，恐會導致護理人員對手術後腸造口病人的評估與照顧完整度不足，影響腸造口的皮膚完整性及合併症的預防。本專案目的為提昇北部某醫學中心大腸直腸肛門外科病房護理人員對腸造口手術後照護的完整性，透過重新規劃腸造口護理在職教育和實務操作訓練計劃、設計腸造口評估表及腸造口辨識卡，落實於臨床照護，使護理人員照護指導完整性由61.8%提昇至98.1%，對於腸造口術後認知由76.9%提昇至97.1%，及相關評估之護理記錄完整性由37.8%提昇至98.8%。專案改善成效顯著，不僅提升護理人員對腸造口術後照護的完整性，也更精進護理人員專業技能，確保病人的照護品質。未來建議將腸造口照護訓練列入實務訓練課程中，以提升護理人員照護能力，並將腸造口評估表內容電腦化於護理作業系統當中，以利護理人員更有效率且完整的執行評估及記錄。

關鍵字

腸造口 ； 術後照護 ； 專案改善 ； 護理

並列摘要

Providing comprehensive postoperative colostomy care can prevent skin irritation and complications for patients. Colostomy care in hospitals is undertaken by stoma specialist nurses. However, relying too much on stoma specialists may result in inadequate care from other nurses in the wards. The purpose of this project was to establish comprehensive colostomy care by nurses in a colorectal surgical ward at a medical center in northern Taiwan. By restructuring the service training program and the practice, as well as redesigning the colostomy assessment checklist and photo cards, the completeness rate of nursing care increased from 61.8% to 98.1%, the nurses' knowledge of colostomy care increased from 76.9% to 97.1%, and the completeness rate of nursing notes increased from 37.8% to 98.8%. This project, therefore, not only accomplished a comprehensive overview of colostomy care, but also improved nurses' professional capabilities within it. We therefore suggest including colostomy care into the inservice training programs in colorectal surgical wards. Integrating colostomy assessment into computerized nursing documentation systems is also recommended for more effective and comprehensive reports of patient assessment and care data.

並列關鍵字

colostomy ； postoperative care ； improvement project ； nursing

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