心臟外科病人藥物指導完整性之改善專案

Medication Instruction Improvement Project for Cardiac Surgical Patients

病人對藥物瞭解程度會影響病人對藥物使用正確性及安全性，護理人員執行藥物指導佔很重要的角色。本專案旨在提昇心臟外科病人藥物指導完整性，經調查某醫學中心之心臟外科護理人員執行心臟外科病人藥物指導的完整性僅65.5%、病人接受護理人員藥物指導後瞭解程度僅64.2%。分析原因為：1.護理人員缺乏完整的藥物認知及未能提供病人個別性的藥物指導。2.藥物指導工具不足。3.未制定完整藥物指導標準流程。經專案小組介入改善措施為：1.製作心臟外科病房常見藥物圖片衛教本。2.建立藥物指導流程。3.修改團體護理指導內容。專案評值結果顯示：護理人員執行心臟外科病人藥物指導完整性提昇至89.8％，同時病人接受護理人員藥物指導後瞭解程度提昇至88.3％，顯示專案介入措施，能提昇護理人員執行心臟外科病人藥物指導完整性。

How a patient understands about the drug he used will affect the accuracy and safety of drug usage. Thus, the nurses play an important role on implementing medication instruction. The purpose of this project is to improve the medication instruction integrity for cardiac surgical patients in a medical center. Before intervention, the medication instruction integrity done by cardiac surgical nurses in cardiac surgical patients was 65.5%, and after receiving the medication instruction; the comprehensive rate of patient was 64.2%. The reasons could be due to (1) the nurses are either not familiar with the medication cognition or overloaded to failure in providing the individual a detail medication instruction (2) a shortage of medication instruction tools and (3) no standard procedure of medication instruction was set up. The specialist team suggested that the intervention strategies should include (1) creating the pictures of accustomed drugs at cardiac surgical ward, (2) setting up the medication instruction procedure, and (3) revising the contents of group nursing instructions. The results showed that the medication instruction integrity done by cardiac surgical nurses in cardiac surgical patients was raised from 65.5% to 89.8%. The comprehensive rate of patient was promoted from 64.2% to 88.3%. According to the results of this intervention, the strategies can improve the medication instruction integrity when cardiac surgical nurse implement the medication instruction.