開胸術後病患執行誘導性肺計量器之改善方案

Improving Training Compliance after a Chest Operation in an Intensive Care Unit

本專案旨在提升術後病患執行誘導性肺計量器之正確率。肺部合併症是造成胸腔手術病患死亡之主因，而術後使用誘導性肺計量器可有效預防肺部合併症產生。經統計本病房自93年7月至9月，術後病患執行誘導性肺計量器之正確率偏低，僅達18.5%，故成立專案小組提出改善方案，期能提升術後病患執行誘導性肺計量器之正確率。於93年9月至94年2月以護理指導單張、手冊及看板，對病患實行床邊個別護理指導，並以監測交班單及病患自我紀錄表追蹤使用情形，專案執行後6個月評值成效結果，顯示術後病患執行誘導性肺計量器正確率由18.5%提昇到92.6%，由上述成果得知本專案的推行，能有效提升術後病患執行誘導性肺計量器之正確率，使術後病患獲得高品質的護理照護。

The purpose of this project was to improve the level of training compliance among chest patients after an operation. Pulmonary complications after a chest operation are a major source of patient mortality. Nonetheless, good patient training can effectively prevent pulmonary complications. A statistical analysis of chest operation patients on our ward from July to September 2004 showed a low training compliance rate of only 18.5%; therefore, we established this project with the hope of improving the quality of training and accurate compliance with the trained tasks. We conducted individual bedside nursing instruction using a nursing sheet, an instructor and a board. Nursing records and self-recording by the patients were consulted during followup and the outcome was evaluated at six months. This showed that the training had increased compliance from 18.5% to 92.6%. This supported the idea that the project had effectively improved training compliance and, furthermore, the program had been able to produce a better quality of nursing care.