提升氣切造口病患傷口護理之專案改善

Improvement Approach of Wound Care with Tracheostomy

本專案目的在提升護理人員對於氣切造口病患傷口護理的認知、執行氣切傷口護理的正確性、及降低氣切病患頸部皮膚缺損的發生率，現況中發現護理人員氣切造口護理的認知僅達77.8％，執行氣切造口護理正確性僅達83％，產生頸部皮膚完整性缺損發生率為38.5％，顯示護理人員對氣切造口傷口護理的認知及護理技術有待提升。因此，綜合以上結果，進行本專案之改善方案：(1)規劃教育訓練，(2)使用氣管切開造口氣切固定帶，(3)建立監控制度。經過本專案改善後，(1)護理人員對於氣切造口傷口護理的認知由77.8％提升100％，(2)氣切造口護理技術正確率達98％，(3)頸部皮膚缺損的比率由38.5％降至19％。透過此專案之改善後，提升護理人員對氣切造口病患的傷口護理。

The purposes of the project were to improve the knowledge and skill of tracheostomy wound care and to decrease the occurrence of skin defect on neck. Before the improvement program, the nurses’ knowledge about tracheostomy wound care was 77.8%, the nurses’ skill of tracheostomy wound care was 83%, and the occurrence of skin defect on neck was 38.5%, indicating the nurses’ knowledge and skill of tracheostomy wound care needs to improved. After analyzing the current procedures, the proposed improvement approaches included: (1) provision of on-the-job training and teaching of tracheostomy wound care; (2) application of privately fixed band on tracheostomy wound care; and (3) establishment of an audit system. After the improvement program, (1) the nurses’ knowledge about tracheostomy wound care has increased to 100%, (2) the nurses’ skill for tracheostomy wound care has increased to 98%, and (3) the occurrence of skin defect on neck has decreased to 19%. The program has improved the quality of tracheostomy wound care.