提升頭頸部腫瘤術後病人自我口腔照護

Improving Oral Cavity Self Care after Head and Neck Tumor Surgery

頭頸部腫瘤術後病人執行口腔照護尤為重要，除了降低感染、促進舒適及預防合併症，良好口腔照護為提升手術成功機率之要因。2015年統計發生5位病人返家口腔照護不佳情形，因此調查發現：病人自我口腔照護正確率僅63.4％、病人對於護理師執行口腔照護指導滿意度僅80.3％。可能原因包括：未制定口腔照護指導標準流程、指導工具內容及合宜性不足、缺乏關懷諮詢追蹤制度等因素。策略：建立頭頸部腫瘤術後口腔照護標準流程，增修訂口腔照護指導工具、製作病人自我口腔照護進度查檢表、制定電訪追蹤關懷諮詢機制等。成效：病人自我口腔照護正確率提升至90.2％，病人對護理師執行口腔照護指導滿意度提升至4.8％，足見專案成效，提升頭頸部腫瘤術後病人自我口腔照護。

The postoperative oral care of head and neck cancer is pivotal, as it decreases infection, promotes comfort and prevents complications, and importantly it is one of the factors that enhances the success rate of surgery. In 2015, a total of 5 patients were dismissed from this ward after being educated for oral care at home. An investigation was undertaken and found that the correctness for self-oral care was only 63.4%, the satisfaction of patients towards the instructions for the oral care given by the nursing staff was only 80.3%. The possible causes included no standard guidelines for oral care, inefficient and inappropriate guiding material, lack of tracking and consultation system. Our strategy was to establish a standard guideline for oral care after head and neck cancer surgery, creating leaflets and manuals for post-operative care of head and neck cancer surgery, designing patient self-care progress sheet, conducting regularly phone interviews. The results showed that the correct rate of self-oral care for patients with head and neck cancers was remarkably increased to 90.2%. The satisfaction of patients towards the instructions for the oral care given by the nursing staff was increased to 94.8% as well, reflecting the improvement strategy of this is clinically useful project had effectiveness. Thus enhancing the patient's awareness for a continuous correct self-care of the oral cavity.