鼻部冰敷物品改善專案

A Project to Improve Nasal Ice Packs

鼻部疾病是耳鼻喉科常見疾病，多尋求中西醫治療，當各項治療無效即選擇外科手術治療。2006年統計該病房接受手術治療的病人數255人，術後鼻部疼痛腫脹是常見的，因此減輕腫脹疼痛就成為最重要的護理工作之一。筆者於臨床照護中發現病人常抱怨術後鼻部腫脹疼痛不適，資料收集發現病人使用冰敷意願低，調查該單位鼻部手術後使用廠商製作鼻型局部冰敷物品之30位病人，結果因其不服貼（100%）、不易固定（100%）、不實用及不方便性（83.3%）等原因，故整體使用率僅達16.7%。透過本專案改善於臨床中找尋替代物品，以橡皮手套裝置50公克碎冰與水，將其集中於其中兩指併緊束，以棉質白色帶子固定於約束處作耳部固定。以自製鼻型冰敷物提昇冰敷使用率，改善其不服貼、不易固定、增加實用及方便性，達減輕疼痛及局部腫脹之效果。專案實施後改善結果顯示：病人使用冰敷意願提昇至96.7%，冰敷物品服貼度提昇至96.7%，容易固定達100%，實用及使用方便達96.7%。專案改善結果顯著，提高病人服務品質降低成本，期此改善方案能提供有需使用鼻部局部冰敷之單位參考。

Nasal problems are a commonly encountered diseases in the ENT (ear, nose, and throat) specialty. People with nasal problems usually seek medical therapy. When the problem cannot resolved by medical therapy then surgery becomes an option. According to statistics of the ENT unit where author served in 2006, 255 patients underwent nasal surgery. Swelling and pain are the most common discomfort symptoms for patients after nasal surgery. After data collection, it was found that only 16.7% of patients were willing to use ice packs, because they attached poorly (100%), were difficult to secure (100%), and were inconvenient to use (83.3%). After seeking an alternative ice pack replacement, the group decided to use a latex glove filled with 50 gm crushed ice and water in its index and middle fingers, tied with shoe laces and tied to the ears. The project involved three periods: preparation, execution, and evaluation. The results showed that 96.7% of patients were willing to use the new ice pack. The satisfaction rate for use of the new ice pack was 96.7%. The results of this project might improve patients' quality of care, as well as cost reduction.