運用翻轉教室提升外籍照顧員執行留置導尿管照護正確率

Improvement of the Accuracy of Indwelling Urinary Catheter Care in Foreign Nurse Aides by Applying Flipped Classroom

背景：泌尿道感染是醫療照護機構常見的感染之一，復健科病房2016年留置導尿管泌尿道感染發生率為3.79‰。目的：專案主旨為提升外籍照顧員執行留置導尿管照護之正確率。方法：現況發現外籍照顧員對留置導尿管照護認知正確率65.3％，照護技能正確率66.0％。專案內容包括實施翻轉教室工作坊、設計自學評估表、同儕互評表、教學目標、購置會陰清潔模型教具、拍攝導尿管照護影音光碟、教學平台及擬定稽核辦法。結果：經專案改善後，外籍照顧員之導尿管照護認知正確率65.3％提升至96.5％，技能正確率66.0％提升至94.8％。復健科病房留置導尿管泌尿道感染發生率由3.79‰下降至0.8‰。結論：護理人員可應用翻轉教室於臨床工作中，以提升外籍照顧員之導尿管照護認知及技能正確率，最終能造福病人及提升護理專業形象與專業能力。

Background: Urinary tract infections are one of the most common infections in medical care institutions. The incidence of indwelling urinary catheter infection at the rehabilitation ward in 2016 was 3.79‰. Purpose: This project aimed to increase the accurate rate of indwelling urinary catheter care by foreign nurse aides. Method: An investigation revealed that the accuracy of knowledge about indwelling urinary catheter care among foreign nursing aides was 65.3%, and the accuracy of care skills was 66%. The project included implementing flipped classroom workshops, designing a self-assessment form, designing a peer assessment form and establishing teaching objectives, purchasing teaching aids of catheterization simulator for training perineal care, creating demonstration videos for indwelling catheter care and teaching platforms, and developing rules for audition and inspection. Results: After implementing the improvement project, the knowledge on indwelling urinary catheter care among foreign nurse aides improved from 65.3% to 96.5%, and the care skills increased from 66% to 94.8%. The results showed that the incidence of urinary tract infection caused by the indwelling urinary catheter in rehabilitation ward decreased from 3.79‰ to 0.8‰. Conclusion: Nursing staff can apply a flipped classroom in clinical practices to increase the knowledge and care skills on indwelling urinary catheter care among foreign nursing aides and enhance the professionalism as well as the ability of nursing staff to eventually benefit patients.