肺部疾病患者之居家照顧者執行肺部照護正確率之改善方案

Improving the Pulmonary Care Abilities of the Caregivers who Care for the Patients with Pulmonary Disease at Home

居家個案常因肺部感染導致反覆性再入院治療，嚴重則引起敗血症與死亡。本專案於2010年11月2日至2011年6月30日期間，經由現況分析發現單位肺部疾病患者之居家照顧者執行肺部照護正確率低，故本專案目的為改善居家照顧者執行肺部照護能力之正確率。擬定解決辦法包括：1.建立標準化護理指導，於居家訪視時提供護理指導及回覆示教；2.成立居家照顧者肺部照護支持團體；3.製作以圖片為主之肺部照護衛教單張；4.製作肺部照護評核表並建立評值追蹤機制。方案執行後居家照顧者對肺部照護認知正確率由54.79%提昇至84.21%、執行肺部照護行為正確率由55.68%提昇至83.54%。顯示專案推行後，能有效改善居家照顧者肺部照護認知與肺部照護行為之正確率。

Pulmonary infection is the most common reason for hospital re-admission of seniors and often causes severe sepsis and death. The nursing care was provided from November 2, 2010 to June 30, 2011. The purpose of this project was to improve the pulmonary care abilities of caregivers who cared for those seniors at home. We found the accuracy of pulmonary care of caregivers for those clients was low. The pulmonary care intervention program included: 1) establish the standard protocol of nursing education for home visits; 2) form the pulmonary care support group; 3) revise and develop the pulmonary care educational pamphlets; and 4) develop the pulmonary care checklist and establish the tracking mechanism for proper evaluation. The pulmonary care knowledge score of the caregivers significantly increased from 54.79% at pre-test to 84.21% at post-test. The pulmonary care behaviors score of the caregivers also significantly increased from 55.68% at pre-test to 83.54% at post-test. The pulmonary care intervention program significantly enhanced the accuracy and appropriateness of pulmonary care delivery by caregivers to those seniors at home care setting.