運用雲端科技照護提升先天性心臟病嬰家屬照護學習成效之專案

Using Cloud Healthcare to Improve Home Learning Efficacy in Congenital Heart Disease Infants

背景：在疫情期間，配合防疫政策探病受到限制，阻礙了加護病房中家屬到院學習照護技巧的機會，造成家屬對學習的滿意度降低，可能反映了他們在缺乏面對面指導的情況，家屬對於學習內容的理解或應用上的感到困難，再者，一些家屬可能因為照顧信心不足，不願意讓病嬰出院而造成了出院計畫的延遲，凸顯了在疫情期間護理健康指導所面臨的挑戰。
目的：運用雲端科技提升先天性心臟病嬰家屬居家照護的知識和技能，以及居家照護學習滿意度。
解決方案本專案以本院雲端衛教平台為基礎，針對先天性心臟病嬰的家屬，開發了一系列個別化的學習影音教材。這些教材內容涵蓋了先天性心臟病嬰的整個治療過程，從診斷到出院後的居家照護技能。家屬可以透過手機、平板電腦等裝置隨時隨地觀看這些影片，以自主學習。同時，導入聊天機器人工具，提供有關病嬰入院護理指導。這些指導內容包含新生兒照護的基本要素，旨在使父母和照顧者具備出院後基本護理的知識和技能。為了確保家屬掌握個別性照護技能，另外安排了床邊實際操作，進行技術回覆示教和知識評值。
結果：在專案實施後，家屬知識分數從79.1分提升至100分，能夠獨立正確執行照護技巧的比例也從30%提升至95%，對於雲端科技照護學習整體平均滿意度提升31.4%，由3.5分提升至4.6分。
結論：本專案能改善臨床護理指導於時間及場地的限制，有效提升家屬居家照護技能學習成效。

Background: During the COVID-19 pandemic, visitation restrictions in line with infection control policies curtailed opportunities for family members to learn essential caregiving skills in the intensive care unit. This limitation decreased satisfaction among family members, possibly indicating their increased difficulties in care due to the lack of face-to-face guidance. Thus, increasing family member understanding of and ability to apply learning content without direct interaction presents a significant and urgent challenge. Moreover, because of lack of caregiving confidence, some family members may be reluctant to facilitate the discharge of critically ill patients, causing delays in discharge planning. These challenges underscore the obstacles faced by nursing health education during the pandemic.
Purpose: This study was designed to utilize cloud technology to enhance the knowledge and skills of families caring for infants with congenital heart disease at home and to assess their satisfaction with the associated homecare learning platform.
Resolution: Based on our hospital’s cloud-based health education platform, a series of personalized instructional video materials was developed for families of infants with congenital heart disease. These materials cover comprehensively the entire treatment process, from diagnosis to post-discharge home care skills, for these patients. To facilitate autonomous learning, the videos in this series were made accessible to the families anytime, anywhere via personal devices such as smartphones and tablets. Concurrently, a chatbot tool was integrated to provide guidance on inpatient care for infants with congenital heart disease, including fundamental aspects of newborn care, with the aim of equipping parents and caregivers with the knowledge and skills necessary to provide basic post-discharge care. To ensure the families acquired personalized care skills, after completing the learning modules, practical bedside training sessions incorporating knowledge and skills assessments were organized for family members.
Results: After project implementation, the average knowledge score for family members increased significantly from 79.1 to 100 (perfect score). The proportion of family members proficient in executing caregiving techniques autonomously also rose impressively from 30% to 95%. Furthermore, average overall satisfaction with cloud-based technology-assisted caregiving learning among the family members rose 31.4% from 3.5 to 4.6.
Conclusion: This project represents a viable solution to providing clinical nursing guidance independent of the constraints of time and location, and effectively enhances homecare-skill-related learning outcomes in family members, especially with regard to caring for infants with congenital heart disease.