提升某老人醫學病房護理人員執行口腔清潔之正確率

Improving the Correct Rate of Delivering Oral Care to Patients by Nursing Staff in a Geriatric Unit

老人醫學病房病人因慢性疾病致身體活動功能障礙而長期臥床，缺乏自我照顧能力。臨床觀察護理人員未重視口腔照護，執行口腔清潔後病人仍有口腔異味重、舌苔厚、嘴唇乾燥、口腔黏膜及牙齒附著殘渣、口腔潰瘍及感染之問題。分析口腔清潔不正確原因為口腔清潔標準不適用、缺乏口腔清潔工具、護理人員對口腔清潔認知不足、缺乏口腔清潔稽核制度。本專案目的為提升老人醫學病房護理人員執行口腔清潔正確率達70%，擬定解決方案為制定規範與標準、請領口腔清潔工具、舉辦在職教育、制定稽核表。專案推行後護理人員執行口腔清潔正確率由20.8%提升為85%，有效達到改善目的，使護理人員更重視長期臥床病人口腔照護，促進口腔健康，提升護理照顧品質。

Patients in the geriatric unit are bedridden due to physical dysfunction caused bychronic diseases, and often lack the ability of self-care. Nursing staff performed non-satisfactory oral care for patients, which lead to bad breath, thick coated tongues, drylips, residue on oral mucosa and teeth, mouth ulcers, and oral infections. Factors thatcontributed to delivering poor oral care to patients by nursing staff includedinsufficient oral care standards, a lack of mouth-care tools, insufficient knowledgeregarding oral hygiene, and a lack of a checklist for oral care practices. The purposeof this program was to decrease the error rate of executing oral care on patients bynursing staff in a geriatric unit to 30%. The solutions to the aforementioned problemswere to set norms and standards for oral cleanliness, apply for mouth-care tools, organize programs for continuing education of oral hygiene, and to design a checklistof completion. These solutions not only raised awareness for oral care and health, butresults of the program showed that the error rate of executing oral care on patients bynursing staff in a geriatric unit decreased from78.2% to 15%.