腦中風病人出院準備服務改善專案

Improvement of Discharge Planning for Cerebrovascular Accident Patients

本專案旨在改善腦中風病人出院準備服務完整性，提昇護理人員對腦中風病人護理指導之執行，協助病人出院後可獲得持續性照護。此專案係對腦神經內科病房護理人員，腦中風病人及照顧者為收案對象，採實地觀察、訪談、並設計腦中風病人出院準備服務認知問卷及護理指導查核表等方式收集資料。經現況分析後發現：護理人員在新病人及住院中高危險篩選執行率僅各為61.3％及48.0％、護理人員對出院準備服務認知為58.0％及腦中風病人出院護理指導執行率為57.7％，綜合分析與檢討，擬定改善對策：舉辦腦中風病人出院準備服務課程、建立腦中風病人照護指引及製作出院準備服務手冊。經專案介入措施實施後，入院及住院中高危險篩選執行率達100.0％，護理人員對出院準備服務認知率達93.1％及腦中風病人出院護理指導執行率達87.0％。顯示經由增進護理人員對出院準備服務的知識及落實護理人員臨床護理指導，可提升病人出院準備服務照護品質。

The goals of this project was to improve the quality of discharge planning for patients with cerebrovascular accident (CVA), including education of nursing care in hospitalization and sustained nursing care after discharge. The study participants comprised of nursing staffs, patients, and caregivers. Data were collected through observations, interviews, and questionnaires. The implementation efficacy in screening high risk group was 61.3% at first day but decreased to 48.0% during the next week. Only 58.0% of nursing staff understand the meaning of discharge planning and 57.7% of them provided nursing care education to the caregivers. The methods of improving quality included discharge planning, nursing guidelines, and development of the discharge planning manual for CVA patients. The results showed that the completion rate of risk screening increased to 100%. The nurses’ knowledge about discharge planning improved from 58.0% to 93.1%. In addition, the completion rate of nursing education increases to 87.0%. In conclusion, adequate training program to nursing staff could improve the quality of care and quality of discharge planning.