提升肝腫瘤射頻燒灼病人照護完整性

Improving the Integrity of Executing in Liver Tumor Patients Receiving Radiofrequency Ablation

病人執行RFA治療中常接獲臨時通知要補送用物，病人治療後常會抱怨砂袋易滑落，需以手扶著而無法充分休息，護理人員亦常反應要補送用物造成工作負荷。護理人員對RFA治療前準備作業完整性84.6％、照護完整性為82.0％。經決策過程選出解決方法為：修訂流程單、設立RFA專用箱、砂袋專用固定袋。經專案推動後護理人員對肝腫瘤RFA治療前準備作業完整性由84.6％提升至98.5％；照護完整性由82％提升至98.7％，專案實施後能提昇肝腫瘤RFA病人照護完整性，提升照護品質。（志為護理，2020;19:2,67-77）

Clinical practice has revealed that during radiofrequency ablation (RFA) treatment, patients were often informed at short notice that they needed to deliver extra medical facilities and medicine. Patients also complained that the sand pockets always slid down following treatment and needed to be supported with their hands; thus, the patients could not rest fully. Moreover, nursing staff responded that their workloads were increased by the task of informing patients to deliver extra medical facilities and medicine. Therefore, we initiated this study to resolve the problem in question. We analyzed reasons for the low integrity of RFA as follows: the RFA pretreatment preparation process was inconsistent, the health education tools were incomplete, pressurized hemostasis failed to meet patients' needs, and artificial ascites were temporarily required. According to these analyses, the project team proposed the following measures: amending the RFA schedule, establishing RFA exclusive box, and fixed support for sand bags. After implementation of these measures, the integrity of nursing staff's hepatoma RFA pretreatment preparation improved from 84.6% to 98.5%, and the patient care integrity improved from 82% to 98.7%. We expect that this project's inclusion in clinical practice can promote the completeness and quality of RFA care in patients with hepatoma. (Tzu Chi Nursing Journal, 2020; 19:2, 67-77)