照護一位大面積燒傷多次手術病患的護理經驗

The Experience of Nursing Care A Patient with Extensive Burns Who Undergoes Multiple Operations

本文在探討一位 17 歲青少年因大面積燒傷經常性進出手術室的照護經驗。照護 期間於 2015 年 8 月 6 日至 2015 年 10 月 19 日,運用 Gordon 十一項功能性健康評估, 藉由術前訪視、會談、觀察、直接護理照護方式收集資料,確立個案有「低體溫」、 「疼痛」、「焦慮」及「皮膚完整性受損」四項護理問題。護理過程中,針對個案手 術過程中給予加強保溫保暖,持續維持個案體溫的穩定,減輕個案因體溫下降造成 的不適;運用燒傷中心及手術室護理人員的專業性,配合止痛藥的使用,並教導個 案緩解傷口疼痛的技巧及,緩解個案的疼痛;與個案建立信任感,主動關懷及提供 手術麻醉的相關醫療資訊,給予個案心理上的支持,降低個案的焦慮不安;提供個 案傷口照護及足夠的營養攝取,使得傷口無感染,順利進行植皮治療,增進傷口癒 合。期望藉由此案例提供手術麻醉相關的護理同仁,在照護燒傷病患時,能協助病 患面臨醫療的焦慮及不安全感,使病患獲得更完整的手術照護,提升手術住院治療 之護理品質。

 

This study describes the experience of nursing a 17-year-old patient who underwent frequent operations for treating extensive burns. The nursing period is from August 6th to October 19th, 2015, during which time the patient’s 11 func-tional health patterns were used for assessments and to collect data during pre- operative visits, interviews, observations and direct care.

The data shows that the patient exhibited low body temperature, pain, anxiety and damaged skin, which required nursing care. In operations during the period of nursing care, the patient underwent heat preservation treatment to ensure a stable body temperature and to relieve the discomfort of a reduced body temperature. Painkillers and nursing care were used for pain relief.

To build trust with the patient, the patient was actively cared for and was given medical information with regard to surgical anesthesia and psychological support to reduce anxiety. Wounds were addressed and an adequate nutritional intake was ensured to prevent infection so after a subsequent skin-graft, an improvement in wound healing was noted.

This case is a reference for surgical anesthesia-related nursing in combat- ing medical anxiety and insecurity and for a regime of complete surgical care to improve nursing care during hospitalization for surgical procedures.