運用多元策略提升股骨骨折術後病人床上運動正確性

股骨骨折病人術後多臥床休息而不敢活動，導致皮膚壓傷及下肢肌力下降，嚴重時發生跌倒，引發小組成立動機。經現況調查分析後，確認專案問題為股骨骨折術後病人床上運動正確率71.3%、護理人員床上運動認知正確率79.1%與指導完整率僅74.5%。解決辦法包括規劃股骨骨折術後病人照護指引與床上運動標準流程、製作多媒體教案、動次動運動祕笈、翻轉小木人及ㄎㄚ（腳）放對角、製作「我9愛運動」提醒標示等輔助工具及舉辦「床上運動高擬真情境教學」。專案改善結果提升股骨骨折病人床上運動正確性至96.6%、護理人員床上運動認知正確率提升至99.1%及指導完整率提升至98.2%；建議未來可運用虛擬實境教學，增加護理人員執行病人床上運動指導教學，提升照護品質。

The immobilization of patients following femoral fractures post-surgery often leads to complications such as pressure injuries, lower limb muscle weakness, and an increased risk of falls. Recognizing these challenges, this project was conceived to address these issues. Through an investigation and analysis of current clinical practices, several key problems were identified: a 71.3% accuracy rate in patient implementation of bed activities post-femoral fracture surgery, a 79.1% accuracy rate in bed activities knowledge among patients, and a 74.5% completion rate of patient education by nursing staff. To tackle these challenges, the project implemented a series of solutions, including the development of care guidelines and standardized bed exercise procedures for post-femoral fracture surgery patients, creation of multimedia lesson plans, provision of exercise tips, utilization of wooden auxiliary tools, implementation of simulation-based bed exercise lessons, and introduction of ''I Love Sports'' reminders and auxiliary aids. The outcomes of the project demonstrated significant improvements: the accuracy rate of bed activities for patients with femoral fractures increased to 96.6%, the accuracy rate of bed movement cognition among nursing staff improved to 99.1%, and the completion rate of patient education reached 98.2%. Based on these results, it is recommended that virtual reality teaching materials be incorporated to enhance nursing staff performance in patient bed movement education, thereby elevating the overall quality of care in the future.