多元策略提升小兒外科門診手術病童照顧者返家照護認知正確率

Multiple Strategies to Improve Accuracy of Aftercare Knowledge in Caregivers of Pediatric Surgery Outpatient

門診手術返家照護品質差，會增加術後合併症、感染及非計畫性再入院發生率。2021年3月單位接獲門診手術病人投書抱怨衛教內容不明確，且時常有小兒外科門診手術返家後來電詢問照護問題，經調查小兒外科門診手術病童照顧者返家照護認知正確率僅54.4%，分析原因為照顧者無法專注、護理指導不連貫、指導單張不完整且缺乏輔助工具、照顧者不會存檔單張、護理指導流程不完善；為提升小兒外科門診手術病童照顧者返家照護認知正確率，運用修訂指導單張、仿真模具拍攝影片及回示教、建置互動式網域平臺，並制定標準流程，小兒外科門診手術病童照顧者返家照護認知正確率提升至91.3%，期望此專案持續推廣，以提升門診手術病童返家照護品質。

Poor quality of care at home after outpatient surgery increases the incidence of postoperative complications, infections, and unplanned readmissions. In March 2021, the unit received complaints from outpatient surgery patients about uncertainty in the content of health education and frequent calls from pediatric outpatient surgery patients asking for care after they return home. The survey found that only 54.4% of caregivers for children in pediatric outpatient surgery were correct in their perceptions of home care. The reasons for this low rate include caregivers' failure to focus, inconsistent care instructions, incomplete instructional leaflets and lack of support tools, caregivers' not keeping the leaflets on file, and inadequate care instruction processes. To improve the correct rate of caregivers' knowledge of home care for the children undergoing outpatient pediatric surgery, we have revised the instructional leaflet, recording videos using simulation models for demonstration and feedback, establishing an interactive online platform, and developing standardized procedures. As a result, the correct rate increased to 91.3%. It is expected that this project will continue to be promoted to improve the quality of home care for children receiving outpatient surgery.