照顧一位流感重症採俯臥治療病人之護理經驗

Nursing Experiences of a Patient with Severe Complicated Influenza Treated Successful Weaning from a Ventilator with Prone Ventilation

本文探討一位中年婦人因流感重症入加護病房採俯臥治療。護理期間為2017年6月8日至6月19日，運用Gordon十一項功能性健康型態評估，確立有氣體交換功能障礙、潛在危險性皮膚完整性受損、照顧者角色緊張等健康問題。透過重症醫療團隊合作，採俯臥治療，改善氧合情況，提供適切的護理措施，避免俯臥導致的合併症，減輕家屬的焦慮，呼吸訓練期間依其個別性訂定訓練計畫，成功脫離呼吸器並轉出加護病房。建議未來可製作俯臥治療查核表，提昇治療前後措施及備物之完整性，製作俯臥治療衛教單張降低家屬焦慮程度。希望藉由本文提供完整地照護經驗，幫助個案渡過急性期，減少流感重症及俯臥治療可能引發的合併症。

This article describes the nursing experience of a middle-aged woman who was sent to the intensive care unit due to severe complicated influenza. The nursing period was from June 8 to June 19, 2017. Gordon's 11 Functional Health Patterns Assessment was used. The identified nursing problems were gas exchange dysfunction, potentially dangerous skin problems such as impaired skin integrity, and caregiver anxiety. Through the cooperation of the intensive care team, using prone ventilation to improve oxygenation. During the treatment, we provided appropriate nursing care, avoiding complications caused by prone ventilation and relieving the anxiety of family members. With a suitable training plan implemented, the patient was successfully ventilator weaned and transferred out of the intensive care unit. A prone ventilation checklist is suggested to improve the integrity of the measures and preparations. A prone treatment leaflet is made available to reduce the anxiety of family members. We hope this article will provide a complete care experience to help patients through the acute phase and reduce comorbidities potentially caused by severe complicated influenza and prone ventilation. (Tzu Chi Nursing Journal, 2020; 19:2, 117-126)