照護一位活體捐贈肝臟患者之手術全期護理經驗

Comprehensive Perioperative Nursing Experience of a Living Related Liver Transplantation Donor

本個案報告是敘述一位活體捐贈肝臟患者接受手術過程之手術全期照護經驗。筆者在護理期間運用Gordon十一項健康功能評估為指引，確立個案有術前之焦慮、潛在危險性手術情境的傷害、知識缺失等健康問題。在手術全期護理過程中，筆者藉由傾聽了解造成個案護理問題的真正原因，並適時提供澄清，增進個案對活體捐贈肝臟手術及肝臟移植手術的了解，並且針對個案身心健康需要提供個別性之護理計畫與措施，並運用手術室護理人員之專業知識及技能，協助個案處理健康問題，渡過手術全期，進而順利出院。筆者希望能藉由此護理經驗，提供手術室護理人員照顧類似個案時，能深入瞭解患者之需求，減少個案術前焦慮問題，提升個案對手術之認識及術後居家照顧之能力，進而達到整體性手術全期護理之目的。

The purpose of this study was to describe the experiences of comprehensive nursing of a living related liver donor. Based on the 11 aspects of Gordon’s health function evaluation, the authors identified the case had the following health issues during the preoperative nursing period: (1) anxiety; (2) risk of perioperative positioning injury; (3) deficient knowledge. During the perioperative nursing care, through effective communication the authors identified the problems specific to the case and addressed each problem by giving clear answers. Not only it allowed the patient to understand the procedure of living related liver transplantation, furthermore, it also helped the nursing staff to formulate a care plan tailored to the mental and physical needs of the patient. The patient’s health issues were addressed and supported throughout the perioperative period safely by the involvement of the professional knowledge and skills of the operating room nurse. The patient had an uneventful hospital stay and was discharged from the hospital without complications. We hope that, through this experience, a holistic approach to perioperative care could be delivered by operating-nursing staff, through effective communication to address the needs of the patient in areas such as minimizing the anxiety, giving insight to the patient and improving postoperative care following discharge from the hospital.