肝臟移植手術後護理指導之改善專案

A Project to Improve Post Liver Transplantation Nursing Instruction

在肝臟加護病房工作期間，常常接到肝臟移植手術後的出院病人來電諮詢有關疫苗注射及免疫抑制劑逾時服用等相關問題，且有自行減藥或停藥案例，而引發排斥反應及病情惡化，因此激發此專案改善動機。經由修訂肝臟移植手術後護理指導內容、規劃手術後護理指導作業流程、以學習光碟及識藥圖卡執行個別性護理指導，結果顯示：護理人員執行護理指導完整率由73.33％提升為91.25％，肝臟移植手術後病人對於護理指導整體滿意度由79.93％提升為92.85％，整體認知程度由84.78％提升至95.25％。本專案結果發現，藉由一致性、系統性多媒體護理指導運用，可明顯提昇肝臟移植病人對手術後護理衛教指導的滿意度及認知，進而達到有效自我照護的目的。

The motivation of this study arises from concerns about deterioration or rejection conditions in liver transplantation patients who had irregular immunosuppressant taking or delayed vaccination problems. We modified the post-transplantation nursing instruction, amended operation process, and performed personal nursing care by education DVDs and medication recognition cards. These measures resulted in improving the nursing care completion rate from 7.33% to 91.25%, the satisfaction of nursing instruction from 79.93% to 92.85%, and the patient’s general recognition from 84.78% to 95.25%.We concluded that nursing instruction using a consistent and systematic multimedia instruction is effective in increasing the satisfaction and enhancing recognition of post- transplantation, leading to more effective self-care.