提昇護理人員對自體乳房重建病人出院護理指導之完整性

Increasing the Completeness of Discharge Nursing Guidance for Autologous Breast Reconstruction Patients

本專案目的是為提昇護理人員對自體乳房重建病人出院護理指導之完整性，調查北部某一醫學中心整形外科病房護理人員共22位，於2017年2月20日至2017年2月28日，使用自擬結構式問卷調查護理人員對自體乳房重建病人出院護理指導的認知，另於2017年4月3日至2017年8月23日訪談21位病人對護理人員提供自體乳房出院護理指導的完整性，調查結果指出護理人員的認知率僅達57.6%，完整性僅達41.0%。因此，經由文獻查證後，本專案透過修訂在職教育課程內容、策劃實務操作訓練、設計資訊化的護理指導手冊及增訂病房常規等策略，使護理人員對自體乳房重建病人出院護理指導認知率提昇至92.1%、完整性提昇至91.5%。本專案確實提昇護理人員認知及完整性，使病人得到更完善的資訊。建議未來能利用此專案設計之資訊化護理指導手冊供個案管理師後續追蹤病人返家後照護狀況，以適時發現病人的問題與需求，並及時提供資訊，進而提升病人照護品質。

This topic was designed in order to increase the completeness of a nurse physician's discharge nursing guidance for autologous breast reconstruction patients. By surveying nurses whom works for a medical center in northern Taiwan, their understanding of the discharge nursing guidance for autologous breast reconstruction patients was tallied. The results show that the nursing staffs only score 57.6% in understanding, while reaching just 41.0% in completeness. Therefore, by revising the program of on-thejob training, planning practical hands-on experiences, designing informative discharge nursing guidance, and updating the ward routine, the nurses 'knowledge rate of discharge nursing guidance increased to 92.1%. In addition, the completeness rate increased to 91.5%. This project indeed increased the understanding and completeness of discharge nursing guidance for the nursing staff, and the patients have benefitted as a result. In the future, this informative discharge nursing guidance is further recommended for case managers to follow up the patients 'condition and to immediately discover these patients' needs and problems.