老人髖關節置換術之護理指導專案

A Project to Provide Instruction in the Nursing of Elderly Patients with Total Hip Replacement (T.H.R.)

本專案旨在改善髖關節置換術後護理指導作業之缺失。經現況調查發現：缺乏髖關節置換術護理指導作業標準，衛教單張內容與現況不符；護理人員對於護理指導內容不瞭解，其護理指導完整率僅33.75%；護理人員對病人護理指導滿意度為2.56分，病人對於護理指導滿意度為2.04分。經由實地觀察、現況分析及文獻查證後，進行解決方案：一、建立髖關節置換術護理指導作業標準與監測工具，包括制訂髖關節置換術「照護標準」、「護理指導標準現範」、「護理指導單張」、「護理指導記錄單」及「護理指導滿意度調查」；二、舉辦教育訓練課程，以加強護理人員對髖關節置換術照護之認知。經實施解決方案後，護理人員執行護理指導完整率達88.56%，且護理人員及病人對護理指導的平均滿意度分別為4.3分及4.36分，顯示專案經由正確的分析，透過制度結構面，人員過程面及監測結果面來進行護理指導改善作業，確能有效的提升護理指導作業品質及達到專案目的。

This project was aimed at improving the nursing of patients who have undergone total hip replacements. investigation showed the following problems with existing nursing instruction in this area: lack of standard instruction, outdated educational materials, a 33.75% rate of completion of instruction lack of familiarity with instruction materials, and an average satisfaction score of 2.56 among nurses who have undergone instruction; The reading for patient's satisfaction with the guidance of nurses was 2.04. After site investigation, status analysis and reference check, we proposed the following program. (1) Establish standards and monitor tools for instruction for nursing total hip replacement patients, including ”Caring standard”, ”Guidance for nursing instruction”, ”Nursing instruction sheet”, ”Notes at nursing instruction”, ”Satisfaction scoring system for nursing instruction”; (2) Carry out a training course to enhance nursing staff's knowledge about caring for patients with total hip replacement. After program had been implemented, a completion rate of 88.56% was achieved, and the satisfaction scores among nursing staff and patients were 4.3 and 4.36 respectively. This result shows that when we undertake reform at various different levels including systemic structure, processing and monitoring this can radically improve the quality of nursing instruction.