系統性出院準備在職教育訓練對護理人員出院計畫成效之研究

Effectiveness of Systematic Discharge Planning as In-Service Education for

背景：出院準備是醫院轉至社區照護之重要過程，然而護理人員對出院準備概念與評估技能不孰捻及對照顧資源了解不足，以致出院計畫不完整。目的：探討系統性出院準備課程介入後，護理人員之出院準備知識、自我效能、出院計畫完整性、課程滿意度及病人對護理照護滿意度之成效。方法：實驗性研究，收案期間自106年2月7日至3月15日，方便取樣某區域教學醫院10個內外科病房護理人員為研究對象，集束隨機分派單位為實驗組70人、控制組65人。以出院準備知識、自我效能、出院計畫查檢表之前後測得分、課程滿意度得分及病人滿意度得分比較系統性課程介入與否對護理人員執行出院計畫之成效。結果：系統性課程介入後，護理人員出院準備自我效能及出院計畫查檢表前後測得分有顯著差異，且實驗組高於控制組。另外，病人對護理照護滿意度，實驗組平均得分高於控制組。結論：系統性出院準備課程有助於護理人員對出院準備自我效能、出院計畫完整性及病人對出院準備護理照護滿意度的提升。 Background: It’s important to make a comprehensive discharge planning in transitioning patient from hospital care to community care. However, lack of knowledge in care resources and concept for discharge assessment of nursing staff will cause the incomplete discharge planning. Purpose: This study is to investigate the effectiveness of systematic discharge planning education intervention for nursing staffs, including discharge planning knowledge, self-efficacy, discharge planning integrity, training curriculum satisfaction and patient care satisfaction. Methods: Experimental research was conducted from February 7 to March 15, 2017. Subjects were enrolled from 10 internal medicine and surgical wards in a regional teaching hospital by convenience sampling method. There are 70 subjects were enrolled as experimental group with systematic discharge planning education and 65 subjects were enrolled as control group with non-training. By scoring the discharge planning knowledge, self-efficacy, and discharge planning checklist before and after the educational intervention, and comparing the curriculum satisfaction score and patient satisfaction score, the effect of systematic discharge planning education on the implementation of discharge plan by nursing staff was studied. Results: After the systematic educational intervention, the self-efficacy and discharge planning checklist of nursing staffs shown significant higher score than the control group. In addition, in terms of patient satisfaction with nursing care, the average score of the experimental group was also higher than control group. Conclusions: The result of this study was shown that the systematic discharge planning education helped to improve the nursing staff’s capacity on discharge planning assessment and knowledge on integrity of discharge planning to achieve the self-efficacy and patient satisfaction.