運用治療性遊戲提升學齡前期病童噴霧治療執行率

Applying Therapeutic Play to Improve Effects of Aerosol Therapy for Preschooler

呼吸道感染是兒童住院常見原因，本單位為兒童內科病房，每月平均約75位的學齡前期病童需執行噴霧治療，發現有63.6％未能確實執行。分析原因為：病童抗拒無法配合、主要照顧者不配合、病童對噴霧器的聲音及煙霧感到害怕、病童治療時間在睡覺、病童不會深呼吸，護理人員護理指導不一致及單位未建立噴霧治療護理指導標準流程。本專案目的是期望能透過專案方式，改善護理人員執行噴霧治療護理指導完整率及提升學齡前期病童噴霧治療之執行率，經專案小組採取的措施如下：規劃噴霧治療在職教育、設計治療性遊戲工具、擬訂噴霧治療照護標準作業指導書及製作噴霧治療護理指導單張等各項措施介入後，結果顯示病童噴霧治療執行率從36.4％提昇至96.4％，而護理人員執行噴霧治療護理指導完整性也從41.4％提昇至97.1％。顯示本專案確實使病童噴霧治療執行率提升，並增進其對治療的正向經驗，進而提升護理照護品質。

Respiratory tract infections are a common cause of children's hospitalization. Our pediatric medical ward administers an average of 75 aerosol therapy to preschool children. We found that 63.6% failed to implement. Possible reasons are as follows. First, children and primary caregivers are uncooperative. Second, children are afraid of aerosol therapy. Third, treatment time disrupts children sleep. Finally, they don't know how to take deep breaths. Consistencies and formality of the health education should be provided to RNs. It is expected by this project that the nurses can increase the rate of the completeness health education for aerosol treatment, and preschool children can increase the implementation rate of aerosol therapy. After organizing in-service education of aerosol therapy and designing therapeutic play, we developed standard operating procedures and a review system for relevant health education of aerosol therapy. The results showed that the improvement of aerosol therapy increased from 36.4% to 96.4% in preschool children, and the completeness of the nurses' instruction in the implementation of aerosol therapy also increased from 41.4% to 97.1%. The project does increase the implementation rate of the children's aerosol therapy, and enhance their positive experience in treatment, and will raise the quality of nursing care.