提升護理人員執行腦室外引流管護理指導完整性

A Project on Improvement of Nursing Personnel’s External Ventricular Drainage Patient Education Integrity

腦室外引流管是腦神經外科常見的手術，若引流量不準確，容易導致病人病情嚴重變化，而影響醫療處置判斷，故專案目的為提升腦室外引流管護理指導完整性。臨床發現護理人員對腦室外引流管認知不一致、缺乏教育訓練、無合適護理指導工具及輔助裝置器材。擬定對策為制訂「腦室外引流訓練流程圖」、「照護標準作業規範」、舉辦「專科在職教育訓練」、製作「照護指導單張」、「多媒體技術教學光碟」、創新研製「腦室外引流裝置器材」，經改善措施實施後，護理指導完整性由64.6%提升為91.1%，達到專案目標。期待本專案成果能因此提升神經外科病房及加護病房腦室外引流管照護品質。

External-ventricular drainage (EVD) is a common procedure in neurosurgery. If the amount of drain-age could not be recorded accurately, it might affect the decisions on medical treatments and then negatively affect the patient’s progress. The goal of this project is to improve the completeness of nursing instruction for EVD care. Based on clinical observation, we found that each nurse had different knowledge and understanding of EVD. They were also lack of comprehensive training and suitable teaching tools and aids for delivering the nursing instruction for patients with EVD. Therefore, the strategies to improve the nursing instruction include drawing-up a flow chart of EVD care, establishing the standard of care, organizing in-service training for the nurses, providing the instruction sheets of EVD-care, developing multi-media teaching aid DVD, and creating a specific hanger for EVD. The integrity of nursing instruction for the patients with EVD increased from 64.6% to 91.1% after the execution of the above strategies. The results of this project could be used to improve the nursing quality of EVD care in neurosurgery department and ICU.