眼部液氣體交換手術後病人趴臥舒適滿意度之改善專案

Project on Improving the Satisfaction of Comfort in Prone Position among Post-operative Patients Undergoing Ocular Fluid Gas Exchange

液氣體交換術為視網膜剝離有效療法，術後須趴臥利用氣體上升原理將視網膜上頂復位，臨床常見病人採趴臥時主訴不適，影響其趴臥意願。因此我們透過改善專案，經問卷分析，趴臥病人中87％有呼吸不順，73％有胸悶情形，探究該兩項主訴，分別有85%與82%病人認為一般床墊是造成上述不適之主因。為此我們將美容床運用至臨床，改造為適合趴臥的床墊，並設計可換洗的趴床包及漏斗狀護墊。專案實施後，主訴呼吸不順及胸悶的病人中分別有97％與87％獲得改善；對床墊舒適滿意度由14％提升至97％，主動趴臥執行率由62％達到91％。此專案不僅滿足病人清潔舒適與安全需求，也提升其主動趴臥執行率，盼此趴床能廣為臨床使用，嘉惠更多病患。

Fluid gas exchange is effective for treating retinal detachment. Patients need to stay in theprone position after operation for the retina to resume its original position by upward air current.Clinically, patients complained of discomfort, adversely affecting their willingness to stay in theprone position. From a survey it was found that 87% of patients staying in this position had breathingdifficulty and 73% experienced chest tightness. Upon further investigation of the two chiefcomplaints, 85% and 82% of the patients felt the main cause of these discomforts due to conventionalmattresses. We applied the concept of 'beauty bed' in a clinical setting. Conventional mattresseswere modified into mattresses suitable for prone position; washable prone bed sheets andfunnel-shape pads were also designed.After implementation of this project, breathing was improvein 97% of the patients and chest tightness was improved in 87% patients. Satisfaction level in thecomfort of the mattress had increased from 14% to 97%. The percentage of patients taking theinitiative to stay in the prone position were improved from 62% to 91%. This satisfied patients'need for comfort and safety; also, it also increased the percentage of patients who took the initiativeto stay in this position.We hope this modified mattress can be widely adopted the a clinical environmentto benefit more patients.