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題名:運用影像傳輸系統提昇護理人員乳房重建術後皮瓣評估一致性
書刊名:長庚護理
作者:李姿燕黃惠珠林玉芬王詩詠陳淑卿 引用關係沈永釗
作者(外文):Lee, Tzu-yenHuang, Hui-chuLin, Yu-fenWang, Shih-yungChen, Shu-chingShen, Yung-chao
出版日期:2014
卷期:25:3=87
頁次:頁291-301
主題關鍵詞:乳房重建皮瓣影像傳輸Breast reconstructionFlapImage transmission system
原始連結:連回原系統網址new window
相關次數:
  • 被引用次數被引用次數:期刊(1) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:1
  • 共同引用共同引用:0
  • 點閱點閱:4
皮瓣顏色對於接受乳房重建術後病人很重要,是顯微手術的關鍵,護理人員皮瓣評估與醫師判斷有誤差,可能延遲異常皮瓣處理,造成皮瓣移植失敗。本專案目的為運用數位影像傳輸模式,通報乳房重建術後皮瓣評估結果,以增加醫護人員於術後皮瓣評估的一致性。現況中發現護理人員對術後皮瓣顏色評估判斷一致性僅65.7%,因通報流程問題導致皮瓣處理時效異常件數3件,通報及處理時間平均為3小時。專案小組經問題分析、探究對策等步驟,設立改善方案包括:(1)運用數位影像即時傳輸皮瓣照片、(2)修改皮瓣色卡、(3)建立異常皮瓣顏色圖檔及(4)修訂病房常規通報流程。經介入上述改善措施後,護理人員對術後皮瓣顏色評判斷一致性提昇至100%,因評估通報流程問題導致皮瓣處理時效異常0件,通報及處理時間縮短為8分鐘。本專案為建立客觀皮瓣評估方法,促進醫護間皮瓣評估溝通,縮短異常皮瓣處理時效,降低再次手術的機率。
Flap color of breast reconstruction is crucial during postoperative period. The inconsistency of flap assessment between nurses and physicians might delay the timing of salvage and resulting in flap graft failure. The purpose of the project was to apply image transmission system to promote consistent flap assessment for breast reconstruction postoperative among nursing staffs. Before the project, the consistency of flap assessment was 65.7%. There had been 3 events of delayed salvage due to reporting process. The average time between reporting and management of flap was 3 hours. After analyzing the current procedures, current project of improvement included: (1) applying digital image to timely transfer flap pictures; (2) modifying flap color cards; (3) building abnormal flap color files; and (4) revising standard reporting procedures. After the improvement project, the consistency of flap assessment among nursing staffs increased to 100%. The number of delayed reporting decreased to 0. The average time between reporting and management of flap decreased to 8 minutes. The project has constructed an objective way for flap assessment, promoted communication between nursing staffs and physicians, and shorten the timing of salvage, and successfully decreased the need for reoperation.
期刊論文
1.黃睦升、蔡美文(20071200)。乳癌術後之上肢問題的醫學新知與物理治療。物理治療,32(6),324-332。  延伸查詢new window
2.林俊銘、陳明君、何信君、洪宏翔(20031200)。病人影像與資料的數位化在長庚醫院的經驗。中華皮膚科醫學雜誌,21(4),353-360。  延伸查詢new window
3.Chen, C. M.、Halvorson, E. G.、Disa, J. J.、McCarthy, C.、Hu, Q. Y.、Pusic, A. L.、Mehrara, B. J.(2007)。Immediate postoperative complications in DIEP versus free/muscle-sparing TRAM flaps。Plastic and Reconstructive Surgery,120(6),1477-1482。  new window
4.Chen, K. T.、Mardini, S.、Chuang, D. C.、Lin, C. H.、Cheng, M. H.、Lin, Y. T.、Wei, F. C.(2007)。Timing of presentation of the first signs of vascular compromise dictates the salvage outcome of free flap transfers。Plastic and Reconstructive Surgery,120(1),187-195。  new window
5.Shameem, H.、Yip, C. H.、Fong, E.(2008)。Immediate breast reconstruction after mastectomy: Why do women choose this option。Asian Pacific Journal of Cancer Prevention,9(3),409-412。  new window
6.Smit, J. M.、Acosta, R.、Zeebregts, C. J.、Liss, A. G.、Anniko, M.、Hartman, E. H. M.(2007)。Early reintervention of compromised free flaps improves success rate。Microsurgery,27,612-616。  new window
7.Spiegel, J. H.、Polat, J. K.(2007)。Microvascular flap reconstruction by otolaryngologists: prevalence, postoperative care, and monitoring techniques。Laryngoscope,117,485-490。  new window
8.王祥亞、鄭明輝、高煌凱、曹中侃(20070900)。Using Microvascular Anastomotic Coupler System for Venous Anastomosis of Internal Mammary Vein in Breast Reconstruction。中華民國整形外科醫學會雜誌,16(3),183-188。  延伸查詢new window
學位論文
1.林佳佑(2008)。乳房問卷(Breast-Q)-乳房重建(手術後)版中文化及相關因素探討(碩士論文)。長庚大學,桃園。  延伸查詢new window
圖書論文
1.吳蕙菱(2012)。急性外科傷口。最新傷口護理學。台北市:華杏。  延伸查詢new window
2.林秋玉(2012)。基本傷口換藥技術。最新傷口護理學。台北市:華杏。  延伸查詢new window
3.蔡新中、蔡新民(2012)。傷口的處理。最新傷口護理學。台北市:華杏。  延伸查詢new window
 
 
 
 
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