提升新生兒加護病房早產兒寧握護理完整性之改善專案

Improving the Completeness of Facilitated Tucking for Preterm Infants in the Neonatal Intensive Care Unit

背景：執行寧握護理可以改善早產兒肌肉張力不足、減輕侵入性處置造成之疼痛以及穩定其生命徵象。目的：為提升護理人員執行寧握護理認知之正確率及執行率。解決方案：制定寧握護理執行的方式及標準化，減少護理人員操作上的負擔，使人員執行可達一致性，製作步驟分解圖示放置於病人單位，並舉辦在職教育課程，利用短片教學，提供護理人員寧握護理照護指引。結果：護理人員於侵入性處置前、中、後執行寧握護理執行率由0％、1.2％及6％提升至53.5％、50％及48.8％，寧握護理認知正確率由61.1％提升至91.9％。結論：透過本專案將寧握護理標準化，使臨床護理人員有所依循，早產兒得到更完善的照護及良好神經發展，同時提升親子依附關係。

Background & Problems: Facilitated tucking (containment) is a strategy that has been demonstrated to improve insufficient muscle tone, reduce procedural pain, and stabilize vital signs in premature infants. Purpose: The aim of this study was to improve the accuracy and implementation rate of nursing staffs’ facilitated tucking. Methods: Formulate and standardize nursing care to reduce the burden on nursing staff and make staff implementation consistent. Decomposition diagrams of the production steps were posted in patient units, on-the-job education courses were held, and a short video was used to provide care guidelines to nursing staff. Result: Compared to pretest levels, the rate of facilitated tucking implementation in the early, middle, and late invasive medical treatment periods, respectively, increased from 0% to 53.5%, 1.2% to 50%, and 6% to 48.8%, while the accuracy rate of facilitated tucking cognition increased from 61.1% to 91.9%. Conclusion: This project effectively promoted the standardization of facilitated tucking in our hospital, provided preterm infants with better care and neurological development, and improved mother-infant attachment.