運用多元策略提升護理人員執行大腸鏡檢腸道清潔完整率

大腸鏡檢是確診大腸癌重要工具，腸道清潔完整與檢查成功率相關。統計2019年1～4月執行大腸鏡檢腸道清潔完整僅57.4％，與高品質大腸鏡檢90％以上評為全乾淨／大部分乾淨相距甚遠，引發改善動機。現況發現：一、人員對腸道清潔衛教認知、行為不一；二、病人無法吸收指導內容以致腸道清潔完整率低；專案目的在提升病人腸道清潔完整率，藉由舉辦在職教育、修訂衛教單張、統一工具、多媒體影片、群組教學等多元策略；使腸道清潔度57.4％提升至90.3％、腸道清潔衛教認知64.4提升至93.1％、執行腸道清潔衛教行為60.5％提升至92.7％，達成專案目的，有效提升人員執行腸道清潔完整率。

關鍵字

大腸鏡檢查；腸道準備；多元策略

並列摘要

Colonoscopy is an important tool for diagnosing colorectal cancer. Adequate and good cleansing in colon and rectum is associated with the completeness and success rate of colonoscopy. According to the record of bowel cleanliness in fibrous colonoscopy from January to April 2019, there were only 57.4% of examined patients who had adequate colon preparation before this procedure. This result was far from the current high quality colonoscopy targeting over 90% of examined patients with an excellent or good bowel preparation before colonoscopy. This urges us to improve the situation. The current issues include firstly the differences in cognitive knowledge and practical procedures of colon preparation between clinical staff members; secondly, inadequate bowel cleanliness rate was low because the examined patients did not completely understand the instructions for colon preparation. This project is aimed to increase the percentage of colonoscopy cleanliness by the following strategies: regular staff education, update the health education leaflet, using standard tools and multimedia for patient's evaluation and education, as well as communication via LINE group. Finally, the cleanliness of colon rate in colonoscopy was increased from 57.4% to 90.3%; the cognition for bowel preparation steps and ability to perform adequate bowel preparation were raised from 64.4% to 93.1% and from 60.5% to 92.7%, and reached the goal of this project. This project had successfully promote staff's ability to carry out patient education and their bowel preparations before colonoscopy.

並列關鍵字

colonoscopy ； bowel preparation ； multiple strategies

參考文獻

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許秋霞、蘇心怡、徐雯娟、林瑞香（2018）．提升護理人員執行內視鏡檢查前衞教指導之完整性．新臺北護理期刊，20(2)，63-73。https://doi.org/10.6540/NTJN. 201809_20(2).0006

國際替代計量

運用多元策略提升護理人員執行大腸鏡檢腸道清潔完整率

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