提升護理人員對植髮術後護理指導之改善專案

Enhancing the Nursing Completence and Ability in Post-Operative Instructions for Patients after Hair Transplantation

本專案目的為提升護理人員對植髮手術後傷口照護及居家護理指導完整性。因此觀察護理人員執行傷口照護與護理指導作業，單位無作業規範、缺乏衛教單及交班機制。返家後再次回診諮詢率高，且擔憂移植的毛囊狀況，影響術後持續性照護品質。因應原因專案成員擬定策略：1.制定植髮術後傷口照護及居家護理指導標準作業規範；2.製作居家護理指導手冊及衛教單；3.多媒體衛教影片；4.製訂護理指導聯繫單；5.專屬換藥室；6.護理人員教育訓練。經過6個月的改善，護理人員術後傷口及居家護理指導認知由改善前72.2%提升到91.5%，術後傷口照護正確執行率68.9%提升至100%，術後居家護理指導完整執行率58.6%提升至97.3%。數據顯示有效改善護理人員執行護理指導的完整性，故應持續推行此專業照護模式，達到預期的術後照護品質。建議應考量整體性醫療及護理評估，彙整個案的需求，後續應將病人滿意度納入護理指導照護品質監測，並延伸主動式術後護理關懷，定期評值與追蹤做為日後研究的方向。

In order to promote the success rate of hair transplantation surgery (HT), We set up the project for enhancing and completing the instructions of post-operative and home-care. Postoperative wound healing and home care are factors that affect the survival rate of transplanted hair follicles. In clinical setting, nursing staff gave nursing instructions based on their individual knowledge and experience without consistency and completeness of nursing care guidelines. We constructed six methods to solve the problems of inconsistency and in-completeness of nursing care.1. Develop the standard guidelines and instructions of wound and home care after HT.2. Design self-care brochure or booklet.3. Design multi-videos on postoperative guidelines.4. Develop recording sheets of nursing interventions.5. Set up professional wound care room.6. Provide continuous education for nursing staff.After 5 months of intervention, staffs had improved the cognitive scale of postoperative and home care score from 72.2% to 91.5%, The correct rate of postoperative wound-care was improved from 68.9% to 100% and completion rate of home-care was improved from 58.6% to 97.3%. The completeness of nursing interventions and the quality of care were promoted effectively. We should take into consideration the whole medical process and the individual needs of every patient, and integrate the patient satisfaction into quality control of nursing instruction in the future. Further, our research could also include active postoperative nursing care and regular assessment and tracking.