新生兒加護病房早產兒正確築巢擺位照護模式之改善專案

Improving the Provision of Nesting and Positioning for Premature Infants by Nurses in Neonatal Intensive Care Units

背景：築巢擺位是護理人員最常執行的發展性照護技術，可提供早產兒舒適臥位、穩定生命徵象、刺激神經肌肉及骨骼關節正常發展。目的：提升護理人員築巢擺位認知、技能的正確性。解決方案：將擺位評估及圍巢的製作標準化，使人員在評估及執行達一致性：製作「築巢擺位卡」及「築巢擺位評估表」張貼在護理病歷本上，並舉辦說明會；利用影片教學，拍攝築巢擺位技能教學及圍巢製作影片提升人員的學習效能；修訂新進人員職前教育內容。結果：護理人員擺位認知正確率由58.3%提升至92.3%、實際擺位正確率亦由63.3%提升至91.4%。結論：本專案將臨床築巢擺位標準化使護理人員執行常規照護時有所依循，提升了照護品質，也使早產兒能得到完善的照護並有良好的發展。

Background & Problems: Nesting and positioning is a common nursing skill used in the developmental care of premature infants. This skill maintains premature infants in a comfortable position, facilitates the monitoring of stable vital signs, and enables spontaneous motor activity for normal neuromuscular and skeletal joint function.Purpose: This project was designed to improve nursing staff cognition and skills regarding nesting and positioning for premature infants in the NICU.Resolutions: Strategies used in this project were: develop an infant position assessment tool; record a demonstration video about nesting and positioning skills to provide learning efficacy among the nursing staff; and modify an education program for new nurses.Results: After implementation, nurse cognition regarding premature infant nesting and positioning increased from 58.3% to 92.3%. The rate of correct technique use similarly rose from 63.3% to 91.4%.Conclusions: This is a valid intervention for improving the correctness of nesting and positioning in nursing care. This project standardized education in terms of nesting and positioning practice goals and enhanced quality care for premature infants.