照護一位接受腎移植個案手術全期護理經驗

A Nursing Experience of Caring for a Patient Undergoing Kidney Transplantation

腎臟移植手術是治療末期腎臟疾病的方式之一，本篇個案報告係探討一位接受腎移植個案接受手術過程之手術全期照護經驗。護理期間於2013年9月28日至10月14日，運用Gordon十一項健康功能評估為指引，確立個案有手術前之焦慮、手術中有潛在危險性手術環境傷害、手術後對於知識尋求等健康護理問題。在手術全期護理過程中，筆者藉由主動關懷、傾聽和同理心了解造成個案護理問題原因，適時澄清以增進個案對腎臟移植手術了解，並針對個案身心健康問題需求提供個別性護理，包括在術前等候區利用術前30分鐘，主動關心個案減少個案焦慮，術後製作藥物圖卡，讓個案更加了解對藥物的認識，運用手術室護理人員專業知識及技能，使其手術住院期間獲得整體性護理，進而順利出院。藉此護理經驗，提供手術室護理人員照顧器官移植病患，能暸解病息需求，減少術前焦慮，提升病息對手術的認識及術後居家照顧之能力，進而達到手術室全期護理目的。

Kidney transplantation is one of the treatments for patients with end-stage renal diseases. This paper explores a nursing experience of caring for a patient undergoing kidney transplantation. The nursing period was from September 28 to October 14, 2013. Gordon's 11 Functional Health Patterns were used as an assessment tool. The identified patient care problems were preoperative anxiety, potential risk for harm during surgical operation, knowledge inquiry post-surgery, and other healthcare problems that the patient encountered. During the perioperative care period, with proactive caring and listening with empathy, the author clarified the patient's concerns about understanding kidney transplantation and provided individualized care based on the patient's problems with physical and psychosocial wellbeing. The author lessened the patient's anxiety during the waiting room period and provided an education session about medication using drug cards after the surgery. With the provision of the operational room nurses' professional knowledge and skills, the patient received comprehensive nursing care and was successfully discharged home. The author shares this nursing experience with other operational room nurses caring for patients undergoing kidney transplantation. The author expects that comprehensive perioperative nursing care can be achieved by understanding the patients' needs, reducing their pre-operative anxiety, and enhancing patients' knowledge about the surgery and home care post-surgery.