一般病房裝置Centri-Mag 心室輔助器病人的照護經驗

Care Experience of Patients with Implanted Centri-Mag Ventricular Assist Device (VAD) in General Ward

心衰竭末期病人在裝置心室輔助器（Centri-Mag VAD）後，可延長生命及等待心臟移植時間。因於加護病房等待期漫長，隔離及活動受限導致病人肌耐力與生活品質降低，有鑒於此，本單位由心血管醫護專家共同擬定穩定心室輔助器（Centri-Mag VAD）病人轉至一般病房照護計畫，藉由轉入前病況評估、人員訓練、環境準備、建立跨團隊合作與緊急應變流程，於2014 年開始啟動本計畫迄今，共有9 位裝置心室輔助器病人，順利轉至一般病房照護，平均等待心臟移植為31 天，至今有8 位病人完成心臟移植，順利出院返家。此計畫，不僅讓病人在心臟移植前，保持良好的肌耐力活動狀況，心理上也獲得家人的溫暖支持，達到以病人為中心的照護理念，且提升加護病房的病床周轉率，讓病人與醫護達到雙贏的境界。

The implantation of ventricular assist device (VAD) can prolong the end stage heart failure patients’ lives and heart transplant waiting time. Previous VAD implanted patients have to stay intensive care unit (ICU), therefore the long bed- ridden time may cause the complications, such as reduced muscle endurance and quality of life. New care program to transfer VAD patients from ICU to general ward was developed and implemented based on opinions from clinical cardiovascular experts. Well organized Centri-Mag VAD patients care plan using comprehensive assessment before transfer, staff training, environmental preparation, establishment of multidisciplinary teamwork cooperation. Nine VAD patients received the comprehensive care program since 2014. Eight patients were received successful heart transplantation and returned home. The average waiting time for heart transplantation is 31 days. Better outcomes of maintaining good muscular endurance, direct support by family, and patient- centered management were achieved by the new care program. Moreover, higher turnover rate of also improve the utilization rate of ICU.