一位施行半人工髖關節置換術個案之手術全期護理經驗

A Perioperative Nursing Experience for a Patient Undergoing a Bipolar Hip Joint Replacement

本文旨在探討運用手術全期議理照護接受半人工髏關節置換術個案之讀理經驗。自2008年8月10日至2008年8月19日，藉由觀察、會談及傾聽等，以手術全期照讓模式為基礎，收集個案手術前、中、後之資料，進行整體性護理評估確立健康問題。主要健康問題有（一）焦慮∕面對手術及麻醉過程產生不確定。（二）潛在危險性傷害∕手術過程維持側臥姿勢與使用電燒器易造成電燒傷問題。（三）知識增進的準備度∕接受體關節置換術後自我照顧知識不足。（四）疼痛∕與組織損傷（手術）有關。在護理過程中，筆者藉由術前訪視，與個案及家屬建立良好互動關係，並透過術中的安全照護、術後的衛教以及出院後電訪個案，給予個案完整的手術全期照護，有助於提升個案自我照顧能力，達到最佳健康狀況，並且能儘快恢復以往之生活。

This article explores the perioperative nursing experience for a patient undergoing a bipolar hip joint replacement. The nursing period was from August 10 to August 19, 2008. Based on the perioperative nursing model, data were collected during the preoperative, operative, and postoperative periods respectively. Through observation, interview, and active listening, the identified major nursing problems were (1) anxiety and uncertainty secondary to the operation and anesthetic procedure; (2) potential injuries and bums due to the operative position and the electrical devices used for the surgery; (3) lack of knowledge regarding the preparation of surgery and self care post surgery; and (4) postoperative incision pain. During the nursing care period, the author made a preoperative visit to the patient, maintained close contact with the patient and families, monitored the patient's safety during operation, reinforced post-operative patient education, and called the patient for a postoperative follow up. These nursing activities promoted the patient's ability of self care and helped the patient achieve the highest level of health and resume personal life at the earliest possible.