降低經皮穿腔冠狀動脈血管成形術後瘀青發生率

The Incidence of Decreased Echymosed after Removal of Sheath in Patient Receiving Percutaneous Transluminal Coronary Angioplasty

本專案旨在降低經皮穿腔冠狀動脈血管成形術病患拔除鞘管後之瘀青發生率，民國年本單位接受股動脈病患人拔除鞘管後之瘀青發生率為。經由現況分析並篩選出可加以改善的原因有：止血期間病患缺乏活動自主性、止血過程病患腰酸背痛不適、止血工具無法有效固定。經由品管圈活動擬定改善對策：制定床上肢體活動衛教單張、改良止血工具、修訂心臟介入性檢查治療後護理監測表、制定止血技術護理標準及查核表，於年月開始推行，並作追蹤評值。實施四個月後瘀青發生率由降至，使病患可以獲得一個安全、有效、舒適的止血過程。

This project aimed to decrease echymosis incidence after removal of the femoralsheath in patients who received percutaneous transluminal coronary angioplasty.The echymosis incidence after removal of femoral sheath was 28.4% among anestimated 379 patients who received percutaneous transluminal coronary angioplastyvia femoral access in our coronary care unit in 2002. Correctable factors thataffected echymosis rate was as follows: 1. Patients lacked daily activity duringhemostasis. 2. Patients felt flank soreness during hemostasis. 3. The hemostasis toolsdid not work effectively. This refinement program designed by our quality controlgroup was as follows: to design health education material, to improve hemostasistools, to revise post coronary artery angiography / intervention monitor table andto design nursing hemostasis technique criteria and exam. The whole study beganin July, 2003 with the following results: The echymosis incidence decreasedfrom 28.4% to 8.3%, 4 months later. Besides patients required a safe, effectiveand smooth hemostasis course.