提升主要照顧者執行腸造口居家照護之完整率

背景：2015年8月至10月，本單位施行腸造口手術病人為11位，因腸造口出現凹陷、疝氣及造口周圍皮膚感染等再入院病人共有4例，佔27.5%。主治醫師也反映病人返診時，常詢問腸造口照護相關問題，甚至發生主要照顧者害怕換造口底座，要求每週至醫院更換造口底座及造口袋，故引發照護團隊執行專案之動機。目的：提升主要照顧者執行腸造口居家照護技能完整率達80%。解決方案：分析問題主要導因包括主要照顧者年紀大及外籍看護多、記不住步驟及具特殊學習需求、護理人員僅提供簡單口述衛教、缺乏居家照護衛教標準流程。設立解決辦法為（一）制定主要照顧者執行腸造口居家照護之衛教標準流程、（二）拍攝腸造口居家照護過程影片、（三）制定腸造口居家護理指導單張、（四）建立行動醫療資訊系統（QR Code）。結果評值：主要照顧者於出院前，執行腸造口居家照護技能由60.3%提升為82.4%；腸造口居家照護認知平均正確率由49.5%提升為81.0%。結論：跨領域資訊化融合專科照護，增進腸造口居家照護完整性，可避免病人發生合併症、降低再入院率。

關鍵字

腸造口居家照護；主要照顧者；居家護理指導

並列摘要

Background: From August to October, 2015, we carried out colostomies on 11 patients. Among them, 4 cases (27.5%) were re-admitted due to depressed stoma, hernia, or skin infections around the stoma. Attending physicians also stated that re-admitted patients often asked colostomy care-related questions. There were even cases that caregivers were afraid of changing the stoma base and requesting to return to the hospital weekly to replace the base of the stoma and the ostomy bag. These patients' needs drive the health care team to perform this project. Objective: To improve the completeness of colostomy care skills of primary caregivers up to 80%. Solutions: We found that the majority of our patients' caregivers were elderly or foreign helpers. They had difficulties to learn ostomy care procedures and skills through nurses' brief introductions, without standard procedures of home care education The main reasons that the primary caregivers could not provide complete home care were. The The problem were handled by: (I) developing the health education standard procedures of colostomy home care for primary caregivers, (II) recording the video of colostomy home care procedures, (III) developing the stoma home care guidance leaflets, and (IV) establishing the mobile health information system Quick Response (QR Code). Results: The average accuracy of primary caregivers’ colostomy-care skills improved from 60.3% to 82.4% prior to patients’ discharge. The average accuracy of primary caregivers in colostomy-care knowledge enhanced from 49.5% to 81.0%. Conclusion: Interdisciplinary informatisation integrated care improves the completeness of colostomy home care and can therefore avoid the occurrence of complications and reduce re-admission rates.

並列關鍵字

colostomy home care ； primary caregivers ； home care guidance

參考文獻

黃金蓮、車慧蓮、葉美玉（2010）．賦能病人教育與護理指導．醫護科技期刊，12（2），149－159。doi:10.6563/TJHS.2010.12(2).7

徐小惠、許美玉、章淑娟、呂基燕、王淑貞、鍾惠君（2014）．腸造口病人之造口相關合併症及預測因子．護理暨健康照護研究，10（3），220－228。doi:10.6225/JNHR.10.3.220

陳美雪、林淑媛（2012）．光碟教學對改善長照機構護理人員在導尿管相關泌尿道知識之成效．護理暨健康照護研究，8（1），61－69。doi:10.6225/JNHR.8.1.63

曾淑榆、謝雅婷、王晶瑩、林秀如、沈永釗、簡麗瑜（2013）．提昇護理人員對術後腸造口照護之完整性．長庚科技學刊，19，137－149。doi:10.6192/CGUST.2013.12.19.12

李虹慧、吳婷婷、張文惠（2014）．運用治療性溝通協助結腸造口個案及家屬學習照護之經驗．榮總護理，31（4），408－413。doi:10.6142/VGHN.31.4.408

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提升主要照顧者執行腸造口居家照護之完整率

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