漏斗胸納氏矯正手術護理指導之改善專案

Improvement of Nursing Instruction on “The Nuss Procedure for Pectus Excavatum”

本專案旨在改善漏斗胸病人接受納式矯正手術後，護理人員所提供的護理指導內容，以增加病人及家屬對術後照護的認知，以及返家後自我照護能力。經現況分析發現護理人員術後護理指導內容完整性及家屬對護理指導整體滿意度及認知程度偏低。經文獻查證並與專案小組討論後，提出解決辦法：一、修訂漏斗胸矯正手術護理指導手冊，增加圖示說明及護理指導日程表。二、制定漏斗胸矯正術護理指導標準流程，病人入院時就給予指導手冊。三、配合病人手術時段，調整在職教育時間。經改善方案實施後，結果：一、護理人員護理指導完整率由70.14%提升至100%。二、提供家屬及病人實際操作回覆示教由22.88%提升至99.35%。三、提供家屬的照顧認知正確性由52.4%提升至95.9%。四、家屬滿意程度由82%提升至94%。漏斗胸矯正手術屬國內新趨勢之治療，期盼藉此改善專案之分享，作為護理人員日後照護此類病患之參考，嘉惠更多病人。

The purpose of this program was to improve nursing teaching on patients after “the Nuss procedure for pectus excavatum” so as to promote the quality of nursing care. After analysis of current condition, both completeness of nursing instruction and satisfaction of family were low. The development of the program improvement was as follows: revision of pectus excavatum surgery nursing pamphlet to include pictures and schedule of nursing teaching; establishment of nursing procedure of pectus excavatum surgery and given to patients on their admissions; and adjustment of continuing education schedule to fit patients’ surgical schedule. After program had been implemented, the results showed that: the completion rate for oral nursing teaching increased from 70.14% to 100%; the rate of correct demonstration back of family and patient after nursing teaching increased from 22.88% to 99.35%; the cognition of family toward care after “the Nuss procedure for pectus excavatum” increased to 95.9% from 52.4%; and the satisfaction of family and patients increased from 82% to 94%. The Nuss procedure for pectus excavatum is a new trend of treatment in Taiwan. The improvement of this program can help nursing professionals in caring this kind of patient.