提昇主要照護者執行慢性病患居家導尿管護理的正確率

Promoting the Implementation Correction Rate of Foley Catheter Home Care for Caregivers of Chronic Disease Patients

主要照顧者良好的照護技能是預防合併症的關鍵。台灣65歲以上的老年人口逐年增加，礙於他們成年子女工作時間的限制，必須仰賴來自菲律賓、越南與印尼，未接受相關照護訓練的外籍看護照顧，語言與文化的隔閡增加彼此溝通的困難。腎病患者返家仍有導尿管留置，如果沒有落實導尿管護理，可能會因反覆感染入院。本專案目的在提昇腎病患者主要照顧者執行居家導尿管護理的正確率。現況發現主要照顧者執行導尿管護理的正確率僅62.5%，主要是沒接受過護理指導、聽不懂衛教內容與沒有合適的衛教工具。經建構雙語、圖文並茂的衛教標準與手冊、運用「1.2.3」策略安排每天衛教流程、以模擬操作與回覆示教，來減少因語言隔閡造成的學習困擾，並將指導的過程訂立稽查辦法。透過改善讓主要照顧者執行的正確性由改善前62.5%提昇到84.1%。隨著全球化讓更多外籍看護投入居家照護，藉此專案分享護理人員面對返家仍留置導尿管的患者，住院期間透過圖片、回覆示教與漸進式的衛教，可提昇主要照顧者執行之正確性，提供安全無虞的照護環境與降低感染的風險。

The skills and abilities of primary caregivers are the keys to preventing medical complications. The elderly population in Taiwan, those age 65 and older, is increasing every year. Due to the time constraints of their adult children, they must rely on unemployed relatives or foreign caregivers from the Philippines, Vietnam and Indonesia. Most of these caregivers have not received adequate training, and patients and their families must face the challenge of language and cultural differences. Chronic disease patients who must return home while still catheterized may be re-admitted to the hospital for recurrent infections if there is no correct implementation of catheter care. The purpose of this project is to promote the implementation correction rate of Foley catheter home care for caregivers of chronic disease patients. The participant caregivers were only able to correctly catheterize patients at a rate of 62.5%, were not able to accept guidance, could not understand the content of health education and had no suitable health education tools. Construction of illustrated, multilingual health education standards and manuals, the use of ordered strategies to arrange the daily educational process and simulated educational tools were used to guide and reorganize home caregivers. This improved the correct rate of implementation from 62.5% to 84.1%. With increased globalization, more foreign caregivers are expected. This project should serve to aid nurses who instruct home caregivers during hospitalization and enhance the rate of correct catheter implementation to provide patients with a safe environment and reduce the risk of infection.