降低開胸手術病人使用誘發性肺計量器不完整率改善方案

Decreasing the Incomplete Rate of Using Incentive Spirometry of Thoracic Surgery Patients

本專案主旨在降低開胸手術後病人執行誘發性肺計量器之不完整率。開胸手術後以肺擴張不全為最常見及最嚴重的合併症，是引發病人術後死亡的主要原因之ㄧ，透過正確使用誘發性肺計量器可預防肺擴張不全的合併症。本病房2010年3月份開胸手術後第一天病人執行肺誘發性肺計量器之不完整率47.1%，本院術後三天內發生肺擴張不全比例高達58.9%，其中又以26.7％病人因術後肺擴張不全使住院天數延長7天以上，故成立專案小組提出改善方案，期能降低術後病人執行誘發性肺計量器之不完整率。本專案改善措施以1.制定使用誘發性肺計量器之標準作業流程2.製作護理指導衛教單張及光碟3.舉辦醫護團隊誘發性肺計量器及疼痛教育訓練4.訂定查檢制度，經6個月推動顯示術後病人執行肺計量器不完整率由47.1%降低為1.4%，可使病人獲得完善及最佳化的照護品質。

The purpose of this project was reduced in patients after thoracotomy performed spirometry induced incomplete rate. After thoracotomy atelectasis is the most common and serious one of the complications and a major cause of death in patients. Through the proper use of spirometry prevented lung complications, the ward in March 2010 the first day after thoracotomy patients performed spirometry induced lung incomplete rate of 47.1 percent, within three days after the occurrence of atelectasis as high as 58.9%, among which 26.7% of patients because of postoperative atelectasis made prolonged hospital stay more than 7 days, so we made a team to reduce postoperative spirometry and induced incomplete rate of device. The project improvement measures were (1) to develop standard operating procedures (2) to make care guide health education leafl ets and CD (3) to make healthcare team toattend spirometry and pain control education program and (4) to set up check list. After six months postoperative the spirometry incomplete rate reduced from 47.1 percent to 1.4%, and the patient got better quality care.