提升護理人員，執行骨科下肢術後病人復健護理指導之完整性

Improving the Completeness of Implementing Rehabilitation Nursing Guidance for Patients Receiving Orthopedic Lower Limb Surgery

術後病人若盡早復健，以利恢復關節活動角度及肌力，亦能減少併發症風險。專案主旨為提升護理人員執行骨科下肢術後病人復健護理指導之完整性，經現況調查發現外科病房護理人員對下肢術後病人復健運動認知率及執行復健運動正確率僅47.5% 及43.9%，其問題為骨科照護經驗不足、缺乏相關教育訓練及護理指導工具、復健輔具不足、無定期稽核制度、無法立即得知復健進度等。經舉辦在職教育課程、製作多種QR Code 護理指導工具、定期稽核制度、增設復健相關輔具──拐杖助行器及骨科輪椅、增設醫令系統復健運動溝通平台及統一復健護理指導流程等方案，推行並持續監測後，護理人員對下肢術後病人執行復健運動認知率及執行復健運動正確率大幅提升為95.7% 及94.4%，可見能有效提升護理照護品質與提供病人安全醫療環境。

Shortening post-surgical recovery time not only restores the angle of their joint movement and muscle strength but also reduces the risk of complications. This study aimed to improve the comprehensiveness of implementing rehabilitation nursing guidance for patients receiving orthopedic lower limb surgery. This study found that in the surgical wards, the completeness of nurses performing rehabilitation exercises for patients receiving lower limb surgery was only 47.5%, and the accuracy was only 43.9%. The reasons included insufficient orthopedic care experiences, a lack of relevant educational training and nursing guidance tools, insufficient rehabilitation aids, a lack of a periodic audit system, and an inability to immediately learn about the progress of rehabilitation. After implementing in-service educational courses, producing QR codes for various nursing guidance tools, establishing periodic audit system, utilizing rehabilitation-related assistive devices-crutches and orthopedic wheelchairs, using a medical order system with a rehabilitation exercise communication platform, unifying a rehabilitation nursing guidance process, and promoting and implementing of a monitoring system, the completeness and accuracy of implementing rehabilitation exercises to 95.7% and 94.4%, respectively. Overall, the aforementioned measures can effectively improve the quality of nursing care and provide patients with a safe medical environment.