門診氣喘病人居家自我監測之現況調查及執行率提升專案

A Survey on the Current Situation of Home Self-Monitoring for Outpatient Asthma Patients and A Project to Improve the Implementation Rate

本專案旨在提升氣喘病人居家自我監測執行率，使居家病人氣喘獲得控制並減少急性發作之危害，由現況調查發現門診氣喘居家自我監測執行率僅達58.3%。調查發現病人：缺乏居家自我監測認知、對藥物認知錯誤、忘記帶藥物出門；護理人員不熟悉自我監測內容及操作方法、無充裕時間說明；缺乏實體護理指導工具、護理指導單張內容缺乏操作說明等。故於專案執行期間舉辦在職教育、製作氣喘居家自我監測健康手冊、多媒體護理指導工具、海報、增設實體指導工具、創新產品吸藥隨身帶等。應用於居家病人後，門診氣喘病人居家自我監測執行率提升至84.3%。建議將本專案推廣至胸腔科病房，提供住院病人學習居家自我監測，有效的控制氣喘以降低居家病人緊急就醫之需求。

This project aimed to identify and improve the rate of implementation of home self-monitoring for patients with asthma for the purpose of controlling their asthma and reducing the harm of acute attacks. We conducted acurrent situation survey, which revealed that only 58.3% of outpatients with asthma practiced asthma-related home self-monitoring. Factors affecting the implementation rate included patient factors—such as lack of awareness of home self-monitoring, misunderstanding of drugs, and forgetting drugs when going out—as well as nursing factors, such as lack of familiarity with self-monitoring content and operation methods, insufficient time for instructions, lack of physical nursing guidance tools, and lack of operation instructions in guidance leaflets. Accordingly, during implementation of the project, in-service education was provided to nursing staff; moreover, tools such as asthma home self-monitoring health manuals, multimedia nursing guidance tools, posters, additional physical guidance tools, and innovative product inhalation pockets were produced. Following the intervention, the implementation rate of home self-monitoring for outpatients with asthma was 84.3%. We recommend that this project be also conducted on the thoracic ward to ensure that inpatients are given appropriate home self-monitoring information regarding how they can keep their asthma under control after discharge and minimize the need for emergency medical treatment.