提升燒燙傷病人植皮手術前後照護完整性之改善專案

The Project for Improving the Pre- and Post-operative Nursing Care for Burn Patients Receiving Skin Grafting Operation

本專案目的在提昇護理人員對燒燙傷病人植皮手術照護完整性，以提昇燒燙傷病人植皮手術成功率。根據現況分析及調查結果顯示，護理人員執行植皮手術前後照護完整性僅76.6%，護理人員對於植皮手術前後照護認知正確性僅78.6%，導致燒燙傷病人對於植皮手術護理指導作業滿意度僅62.8%。藉由建置植皮手術護理指導工具、舉辦植皮手術專科性在職教育課程、訂定植皮手術前後照護標準流程、訂定定期稽核機制等措施，改善後護理人員對於執行植皮手術前後照護完整性由76.6%提昇至100%，護理人員對於植皮手術前後照護認知性由78.6%提昇至100%，燒燙傷病人對於植皮手術護理指導作業滿意度由62.8%提昇至100%，專案目標達成且效果顯著，可強化護理人員執行燒燙傷病人植皮手術照護能力，提高臨床護理照護品質，進而提昇燒燙傷病人植皮手術成功率。

Skin grafting surgery is one of the mainstream treatments for deep burn wounds. It does not only reduce pain sensation in patients with major burns but it also avoids possible wound infection and further body fluid loss. However, nursing care for pre- and post-skin grafting procedures was inconsistent among the nursing staff, indicating that there was room for improvement. Methods for improvement included: 1. Making flow charts for pre and post operative skin grafting nursing care; 2. Creation of check lists; 3. Using nursing instruction boards; 4. Continue nursing educational training; 5. Designing of booklets for the patients and family members regarding pre and post operative skin graft care. The recognition regarding skin graft nursing care among the nursing staff has risen from 78.6% to 100% after intervention. The ability to execute the complete set of skin graft nursing care has risen from 76.6% to 100%. Patient satisfaction has increased from 62.8% to 100%. We would like to share our experiences regarding the improvements we have achieved through the above mentioned methods in order to accomplish the best nursing care for skin grafting patients.