運用心智圖，提升手術室護理人員執行肺臟移植手術護理之完整性

Use Mind Map to Improve the Integrity of Executing Perioperative Nursing for Lung Transplantation Operation

移植手術常是忽然而至的，一旦接獲通知，手術室護理人員必須精確且快速的做好所有準備並完整的執行手術護理，以利肺臟移植手術可順利的進行。然而肺移植手術個案數少，幾乎是可遇不可求，護理人員對手術流程不熟悉，導致移植手術時間延長，同時亦影響器官保存之品質，更甚至會降低移植之成功率。現況發現：人員經驗少、肺移植手術之認知正確率僅51%、準備清單過舊、未舉辦有效之教育訓練、手術流程無標準化，以致於護理人員執行肺臟移植手術護理完整性低僅72%，故引發改善動機。專案目的在提升術室護理人員對肺臟移植認知率達85%，手術護理完整性提升至90%。解決辦法：導入心智圖學習、舉辦在職教育與模擬手術工作坊、建構用物準備清單。專案改善後，護理人員對肺移植認知提升為96%，執行肺臟手術護理完整性增加至96% 達專案目的，期望以此可延續捐贈者的大愛及讓受贈者獲得更好的手術醫療品質照護。

The occurrence of lung transplant operations is unpredictable. Once the transplantation had been arranged, the operation room nurse should prepare all details exactly and quickly during a short period, and perform surgical care completely. However, since lung transplantation is relative rare, most of the operation room nurse are not familiar with the process of operation, which influences the fluency of the operation. Nursing staff is not familiar with the surgical procedure, which leads to prolonged transplantation time, and also affects the quality of organ preservation, and even reduces the success rate of transplantation. In recent report, the completeness of operation room nursing care in lung transplantation was only 72%, which could attribute to inexperienced members, low recognition(only 51%), outdated preparation list, lack of effective training program, and learning from uncertified experiences. Due to the above problems, we planned a project to improve the accuracy of lung transplant operation. The methods include: mind map import, learning workshop of simulated surgery and in-survive education, re-construction of preparation list. After the project, the accuracy increased to 96%; the completeness of operation room nursing care increased to 96%. The project improves the surgical quality and ensures donors’ love to carry on.