急診氣喘病童重複就診之專案改善

The Decrease in Emergency Room Re-visit Rate-in Asthmatic Children

本專案主要目的是於民國90年1月1曰至5月31曰間為改善72小時內急診氣喘病童重複就診率，選取北部某教學醫院內急診以氣喘病童家屬及護理人員為收案對象，資料收集工具包括病童家屬及護理人員對氣喘疾病認知調查表及執行吸入型藥物操作觀察表、護理人員對氣喘病童衛教執行率及正確率調查表，各為20題，滿分各為20分。經由製訂與實施兒科氣喘病童居家照護方案後發現：（一）病童家屬及護理人員對氣喘疾病照護知識正確性，各平均總分由11.47分（57.35%）及14.53分（72.65%），提升為19.26分（96.3%）及19.60分（98.0%）；病童家屬及護理人員執行吸入型藥物操作，對（Berotec）定量噴霧吸入器及氣喘藥物（Pulmicort）乾粉吸入器平均操作正確性8.32分（41.6%）及8.82分（44.1%），提升為19.10分（95.5%）19.70分（98.5%）。（二）護理人員衛教執行率及正確率各由15.0%及10.25%，提昇至73.3%及70.5%。（三）最後，氣喘病童因72小時內再次入急診就醫由53.31降至6.60%，較改善前下降46.71%。結果顯示，經由改善方案介入後，因72小時內再次入急診之氣喘病童明顯減少，因此本專案執行成果可提供護理人員照顧此類病童時之參考。The purpose of this project was to investigate the decrease in emergency room re-visiting rate within 72 hours in asthmatic children. From May 31, 2001 to January 01, 2001, the asthmatic children’s family and nursing staff in an emergency room in a northern Taiwan teaching hospital were recruited. The questionnaires included the cognition of asthma and the use of medication inhalator by children’s family and nurses in emergency room. These questionnaires consisted of 20 questions and total scores were 20, respectively. In addition, the questionnaire also included the performance and accuracy rate of discharge education in nurses of children, sfamily. After the application of an asthma home care program, results showed that: (1). the cognition of asthma in children’s family and nurses increased from 11.52 ( 57.6% ) and 14.6 ( 73.0% ) to 19.26 ( 96.3% ) and 19.60 ( 98.0% ) . (2). the use of medication inhalator ( Berotec and Pulmicort) in children’s family and nurses raised from 8.32 ( 41.6% ) and 8.82 ( 44.1% ) to 19.10 ( 95.5% ) and 19.7 ( 98.5% ) . (3). the performance and accuracy of discharge education in nurses to children’s family raised from 15.0% and 54.0% to 81.0% and 89, 0%, respectively. Finally, emergency room re-visits within 72 hours decreased from 53.31% to 6.60% in asthmatic children. After intervention program, the emergency room re-visits within 72 hours in asthmatic children significantly decreased. The results help nurses to increase the quality of care in asthmic children.