照護一位全髖關節置換術個案之手術全期護理經驗

An Experience of Perioperative Nursing Care of a Patient Who Underwent Total Hip Replacement

本文在描寫照護一位罹患嚴重退化性髖關節炎病人接受全髖關節置換術之手術全期之護理經驗。筆者自2007年5月11日至5月16日護理期間以手術全期護理概念並運用Watson關懷理論為指引，藉由持續地關懷、觀察、身體評估、術前及術後給予訪視、術中全程照護等技巧收集資料，歸納出主要健康問題有：焦慮、潛在危險性傷害、急性疼痛及自我照顧能力缺失。提供全髖關節置換術之手術醫療資訊及教導預防人工髖關節脫臼護理措施，亦藉由護理人員及家屬的關心及支持，克服疾病手術所帶來之衝擊，減緩焦慮程度，並激發起自我學習照顧動機。願此個案之照護經驗，能提升人工髖關節置換病人之手術全期護理品質。

This report elaborated on the perioperative nursing experience of a patient who had suffered from degenerative hip osteoarthritis and had received total hip replacement. Based on the concept of perioperative nursing care and the guidelines from Watson’s theory, we provided our nursing through tender care, close observation, physical evaluation, pre-operative and postoperative visits, and intraoperative nursing care for this patient during his hospitalization from 11 May 2007 to 16 May 2007. We collected pertinent data for analysis. Major health-related problems have been sorted out as follows, anxiety, potential risk of injury, acute pain, and deficiency of self-care ability. Provision of current information of total hip replacement, education for prevention of artificial hip joint dislocation, tender care and support from nursing staff and family, are important measures to overcome the impact bought by the surgery, to lower the severity of anxiety, and most importantly to motivate patient’s sense of selfcare. Finally we hope that our report could provide some help to improve the quality of nursing care for patients who need total hip replacement.