門診鼻腔沖洗術護理指導改善方案

Improving the Nursing Instruction Program on Nasal Irrigation Technique in Outpatient

本專案旨在提昇門診鼻科手術後病人居家時正確執行鼻腔沖洗術，降低回診時重複護理指導率。以某醫學中心民國93年6月至12月鼻科門診病人為對象，改善前發現病人雖在前次門診時接受過鼻沖洗術護理指導，卻有42%的病人再返診經醫師診視時發現鼻腔內仍有膿稠分泌物或結痂，因而醫師常要求護理人員需再指導病人。分析原因主要為護理人員及病人對於鼻腔沖洗術的認知不足、護理指導單張內容說明不清楚、護理指導輔助工具不足及未回覆示教等，在介入在職教育、制定標準、修訂護理指導及增加輔助護理指導工具等措施後，護理重複指導率降至12%。

This program was organized to reduce the instruction rate of repetitive nursing care in the next visit ofoutpatients when the patients were set to use nasal irrigation technique at home.This research is based on the patients of rhino-OPD during the period of June to December in 2004.There was an intervention of on job training, and an Standard Operation Procedure was set up. The nursingcare instruction sheet was revised and sufficient adjunctive nursing care tools were increased. The instructionrates of repetitive nursing care was significantly reduced from 42% to 12%. These experiences of improvementare very valuable and can be used as guidelines for clinical nursing care in the future.