強化長期血液透析病患之主護護士照顧模式方案

A Model for Strengthening Primary Nursing Care for Long-Term Hemodialysis Patients

本專案主要目的在改善長期血液透析病患之主護護士對病患的護理照顧。資料收集以回溯性透析護理記錄查閱法及實地調查法作問題分析後發現主護護士對其所負責之長期透析病患照顧時間少，護理記錄不完整，且未確實執行追蹤評值護理成效，而訂立改善的措施。改善方案包括1.重新規劃護理人員派班方式、病患的主護護士及訂定主護護士職責。2.修訂病患的護理問題追蹤評值表及病患對護理服務滿意度調查表。專案實施前後評值結果如下：1.主護護士對其負責的長期血液透析病患透析時次數增加，照顧率由16%提昇至31.1%。2.主護護士對病患護理問題的追蹤評值執行率由35%提昇至100%。3.病患對護理服務滿意度由4.07增加至4.38。由此專案實施，確實改善護理人員對病患之照顧，而增加病患對護理服務的滿意度。

The purpose of this project was to improve primary nursing care for long-term hemodialysis patients. By reviewing the retrospective dialysis nursing care records and on-site visits, data were collected and analyzed. We found that primary nurses did not spend enough time with the patients, nursing records were incomplete, arid patient's follow-up and nursing evaluations were not being adequately performed. To improve those problems, we established and implemented some improvement strategies as follows: (1) re-arranged the nursing schedule, appointing primary nurses follow-up checklist form and the patient's satisfaction survey. After implementing these new practices, the project evaluation showed that: (1) increased the frequencies of nursing services for the long-term hemodialysis patient from 16% to 31.1%; (2) increased nursing follow-up tracking performing rate from 35% to 100%; and (3) improved patients' satisfaction from 4.07 to 4.38. The overall outcome of the project was that we improved our nursing care quality and gained more satisfaction to our services from our clients.