腦中風病人灸療處置護理指導之改善方案

The Improving Project ofNursing Ins的lction on Patients with Stroke Undergoing Moxibustion Therapy

近年來中醫灸療在腦中風復健處置成為重要復健之一，不完整的灸療護理指導，容易發生燙傷事件及影響灸療成效。本專案皆在提升腦中風病人灸療處置護理指導之改善專案及成果，通過問卷、實際觀察及訪談進行現況分析，結果發現： （1）病人灸療處置護理指導衛教單滿意度低；（2） 護理人員執行灸療處置護理指導率低。經由專案改善介入措施包含：修定灸療標準作業規範、灸療衛教單張及舉辦灸療在職教育等。專案成效評值顯示： （1）病人對衛教單張內容之滿意度40%提升至92.0% ； （2） 護理人員灸療處置護理指導之完整率由29.2提升至95.8% 。結果顯示本專案改善提升腦中風病人灸療處置護理指導完整性及病人灸療護理指導滿意度，期望本專案之成功經驗可做為它院提昇醫療服務品質之參考。Moxibustion is a common intervention of rehabilitation on patients with stroke. Patients and family would not adhere to the treatment of moxibustion without comprehensive nursing instruction of moxibustion provided by nursing staffs. Thus, the project aimed at developing and implementing the project and outcomes of intact nursing instruction of moxibustion for stroke patients via questionnaires, observations, and interviews collecting data. The findings before the project were low intact rate of nursing instruction (29.2%), low satisfaction level of patients or families on moxibustion pamphlets (40.6%), the unmet learning needs of patients about providing different types of pamphlets and the content of moxibustion pamphlets, and the lack of moxibustion knowledge in nursing staffs. We revised the content of moxibustion pamphlets, revised the standard care of moxibustion, and held inservice education of moxibustion therapy. The results after the project showed that 95.8% intact rate of nursing instruction of moxibustion, 92.0% of patient satisfaction level on moxibustion pamphlets, and 94.3 mean point of nurses' knowledge test of moxibustion therapy. This project can promote the intact nursing instruction of moxibustion and nursing instruction satisfaction level of patients with moxibustion therapy. We hope this successful project can be the reference of other hospitals for enhancing the quality of medical care.