提升整形外科病房護理師對淋巴水腫超顯微手術照護完整性

Enhancing the Completion Rate of Nursing Care for Patients with Lymphedema Undergoing Supermicro Surgery in A Plastic Surgery Ward

淋巴水腫為淋巴系統受損而導致的慢性狀況，不僅影響個人外觀且易導致蜂窩性組織炎，造成病人生活品質低落。近年來，臨床處置已證實淋巴水腫以超顯微手術治療可改善病人症狀並降低感染風險，而術後照護完整與否影響治療成效。經實際檢視目前病房內進行此類病人護理照護完整率僅為65.3%，現況調查分析發現主要是因護理師對照護認知不足以及缺乏適切的衛教工具及相關訓練課程等因素所致，故本專案之目的為提升整形外科病房護理師對淋巴水腫手術照護之完整性。專案小組依現況分析結果擬定改善策略，包括制訂照護工具書、舉辦認知訓練、製作標準化手冊、徒手淋巴引流指導，以及照護衛教包等。執行後結果顯示本專案有效提高護理師執行淋巴水腫術後照護完整率至98.4%，不僅增進護理師照護信心，更進一步提升病人滿意度。藉由本專案改善的成果，提供日後照護類似個案之參考，以提升整體護理品質。

Lymphedema is a chronic condition caused by a compromised lymphatic system. It not only affects personal appearance but also increases susceptibility to cellulitis, often reducing patients’quality of life. In recent years, supermicrosurgery has been proven effective in alleviating symptoms of lymphedema and decreasing the risk of infection. However, successful surgical outcomes rely heavily on high-quality nursing care for lymphedema patients. A situational analysis revealed that the completion rate of care for lymphedema patients in the plastic surgery ward was only 65.3%. The survey identified several issues: insufficient knowledge among nurses regarding lymphedema care, a lack of appropriate health education tools, and the absence of dedicated training courses. To address these challenges, this project aimed to improve the completion rate of care provided by plastic surgery ward nurses for post-surgical lymphedema patients. Based on the situational analysis, the improvement strategies implemented included: establishing guidelines for lymphedema care: providing education and training for nurses; developing a standardized care manual for lymphedema patients; creating instructions for manual lymphatic drainage for nurses; and preparing a care package for patients. After implementing these strategies, the completion rate of care significantly increased to 98.4%. Notably, these improvements enhanced nurses’confidence in providing care for lymphedema patients, increased patient satisfaction with the quality of care, and ensured optimal post-surgical outcomes for patients with lymphedema.