運用多元化教學策略提升二年期護理師對心導管照護完整率

Using Diversified Teaching Strategies to Promote the Integrity of Post Cardiac Catheterization Care in Post Graduate Year II Nurses

臨床實務發現二年期護理師，照護心導管術後病人時，當發生異常狀況，常會出現慌亂需尋找資深護理人員協助，無法發揮護理獨特功能。且近期發生病人接受心導管檢查後出院返家，因發生動脈阻塞合併症造成醫療爭議事件，更加深害怕照護心導管病人，術後需清楚認知病人潛在危險，要更謹慎照護，故引發專案改善動機。依現況分析瞭解後發現：二年期護理師對心導管照護正確率偏低、教學工具未完善、未規劃模擬教學。故藉由專案介入改善方案：舉辦在職教育課程、舉辦情境模擬教學、人形圖應用與案例討論、運用創意口訣記憶法、使用心導管照護教學影片學習等。專案措施介入後心導管檢查照護完整率也由68.9％提升94.4％，心導管認知測驗正確率由62.2％提升95.6％，顯示專案介入措施成效顯著。

Post Graduate Year II (PGY II) nurses were generally inexperienced in taking care of post cardiac catheterization patients. Especially under emergent conditions, many of them could not professionally handle the situation and seeking for help from senior nurses was their ultimate solution. Recently, a patient who received cardiac catheterization had an acute arterial occlusion attack at home soon after his discharge. This incident developed into a medical dispute and many PGY II nurses thus feared to take care of post cardiac catheterization patients. To understand the problem facing PGY II nurses and to improve the nursing care for post cardiac catheterization patients motivated this study. Our study revealed that first, the correctness of post cardiac catheterization care was generally low in PGY II nurses. Second, teaching facilities were inadequate. Third, simulation teaching was lacking. Thus a series of improvement strategies has been implemented in the improvement program. These included in-service training courses, simulation teaching courses, humanoid diagram application, case studies, creative mnemonic memory methods, and teaching videos of post cardiac catheterization care. Our results showed that the correctness of post cardiac catheterization care increased from 68.9% to 94.4%, and the correct recognition rate of cardiac catheterization increased from 62.2% to 95.6% in PGY II nurses. We concluded that these interventions may improve the nursing skill of PGY II nurses when facing post cardiac catheterization patients.