冠狀動脈成形術術前準備完整率改善方案

The Improvement Project of Decrease Preparation Incomplete Rate in Percutaneous Transluminal Coronary Angioplasty

冠狀動脈成形術是冠狀動脈狹窄主要之治療方式，如何讓護理人員在忙碌的工作中，提供病患完整的冠狀動脈成形術術前準備，是護理人員重要職責之一。本專案以全面品質管理之概念成立跨單位品管圈，希望能降低冠狀動脈成形術術前準備之不完整率，改善前發現冠狀動脈成形術術前準備不完整率為68%，經分析後發現問題為未確實核對、認知不足、醫囑開立不完整及臨床路徑表內容繁瑣填寫不完整，經專案設計，制定冠狀動脈成形術病患照護標準及醫囑範本，並建立稽核制度後，冠狀動脈成形術術前準備之不完整率降至15%。因科內醫護同仁共同參與，專案實施後，除了提供病患更優良的照護品質，也促進了醫護團隊默契。

The study purpose was to make aware of the impact of psychosocial factors in major adolescent depression. The results have implications for designing interventions aiming at preventing the occurrence of major depression. A case control study design was used. 47 convenient samples were selected from a medical center diagnosed as major depression and 128 students from a high school with non-psychosis. Data were analyzed by multiple logistic regressions. The result showed that anger, transferring to negative strategies, positive coping skills in seeking medical help, negative thoughts toward future, and perfectionism were significant with depressive cases. Implications for nursing practice and future study are also suggested.