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提升胸腔科住院病人操作定量噴霧劑正確性之改善方案

Improving the Accuracy of Pressurized Metered Dose Inhaler for Inpatients of a Chest Ward

摘要


臨床常用定量噴霧劑來減緩肺部呼吸道症狀,降低急性發作頻率。臨床發現病人在指導後操作pMDI(Pressurized metered dose inhaler)正確率僅為52.6%,護理指導一致性46.7%。確立要因為現行規範不完整、護理指導不一致、步驟難記、無pMDI動態護理指導教材與缺乏吸藥練習工具。解決辦法:修訂規範完整性、制定操作pMDI正確性查核表與護理指導一致性稽核表、創作pMDI操作流程順口溜、製作操作圖卡和動態教學影片、創新pMDI練習工具。改善後病人操作pMDI正確率95.8%,護理指導一致性100%,不僅可提升pMDI用藥的正確性,也可減少護理師反覆護理指導的時間,更能提升整體照護品質。

並列摘要


Pressurized metered dose inhaler (pMDI) are commonly used to relieve pulmonary respiratory symptoms and reduce the frequency of acute attacks. This study found that pMDI were used accurately 52.6% of the time, and patient education was consistent 46.7% of the time. The main reasons for this finding were incomplete usage specifications, inconsistent nursing instructions, difficulty remembering steps for inhaler use, lack of dynamic patient education, and lack of practice with drug inhalation. The solutions tested included devising more complete usage specifications, formulating checklists for correct pMDI use and patient education consistency, creating jingles to facilitate memorization of steps, producing device operation charts and teaching videos, and developing practice tools. Following these steps, patient accuracy in using pMDI improved to 95.8%, and the consistency of patient education was 100%. Thus, the solutions improved the accurate administration of pMDI medication and reduced the time required for nurses to provide patient education, improving the overall quality of care.

參考文獻


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