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題名：探討壓瘡防治多元教學策略對護理人員認知及病人壓瘡發生率之影響
書刊名：榮總護理
作者：吳秀玲／莊秋萍／林麗華／鄒怡真／熊道芬／桑潁潁／洪世欣／黃子珍／周幸生
作者(外文)：Wu, Hsiu-ling／Chuang, Chiu-ping／Lin, Li-hwa／Tsou, Yi-chen／Hsiung, Tao-fen／Sang, Yiing-yiing／Hung, Shih-hsin／Huang, Tzyy-jen／Chou, Shin-shang
出版日期：2017
卷期：34:2
頁次：頁118-129
主題關鍵詞：多元教學策略；護理人員認知；壓瘡；壓瘡發生率；Multistrategy education program；Nurse cognition；Pressure ulcers；Pressure ulcer incidence rate
原始連結：連回原系統網址new window
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  • 被引用次數被引用次數:期刊(2) 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:2
  • 共同引用共同引用:3
  • 點閱點閱:3
本研究目的係運用壓瘡防治多元教學策略進行教育訓練，探討護理人員壓瘡照護之知能及對全院病人壓瘡發生率之影響。研究於北部某醫學中心施行，以實證指引為基礎設計6 小時壓瘡防治課程，利用課室教學、即時互動回饋及情境模擬等多元教學策略進行10 場教學(2016.08.02-22)，以測驗卷測量護理人員教育前後壓瘡認知之差異。擷取該院通報壓瘡指標資料分析教育介入前(2015.09-12)、後(2016.09-12) 相同四個月份之病人壓瘡發生率。全院50.4% 臨床護理人員(924位) 參與，壓瘡認知之後測較前測平均分數提高19.0 分(p ＜ .0001)；一般病房壓瘡發生率在教育介入後顯著下降(0.124%, p = .009)，部位以薦骨為最多，二級發生率下降0.026%。加護病房壓瘡發生率在教育介入後亦顯著下降(0.152%, p =.006)，甚至低於全國醫學中心壓瘡發生率平均值(0.328%)。一般病房發生壓瘡病人平均年齡超過70 歲，且以男性及內科病人為最多，壓瘡危險因子評估表並未納入上述選項，未來可考慮加入壓瘡危險因子評估之選項及教育訓練之內容。
The purpose of this study was to explore the differences in nurses' cognition regarding pressure ulcer (PU) prevention and treatment, as well as the pressure ulcer incidence rates (PUIRs) in patients before and after the implementation of a multistrategy education program. A 6-hour program was developed based on evidence-based practice guidelines, combining lectures, interactive response systems, and simulation teaching strategies. A total of 10 sessions were held (2016.08.02-22) for clinical staff nurses. A questionnaire was used to measure the differences in nurses' cognition before and after the session. The data regarding patients' PUIRs (2015.09-12 and 2016.09-12) were provided by hospital PUIR reporting systems to the Taiwan clinical performance indicator (TCPI) system on a monthly basis. A total of 924 nurses attended the program. After the program, their mean cognition scores were higher (p ＜ .0001), and PUIRs and stage 2 PU rates were significantly lower in general wards. In critical care units, the PUIR was improved (0.152%, p = .009), and even lower than the average data in the TCPI system (0.328%). The study results confirm the importance of multistrategy education programs in reducing PUIRs. PU was significantly more common among male patients, aged over 70 years and in patients staying in medical units. A greater emphasis should be placed on risk factors that are not listed on assessment tools.
期刊論文
1.Moore, Z.、Price, P.(2004)。Nurses' attitudes, behaviours and perceived barriers towards pressure ulcer prevention。Journal of Clinical Nursing，13(8)，942-951。  new window
2.鍾卉庭、徐玲蕙、潘昭君、楊淑燕、陳婉宜(20110600)。降低外科加護病房病人壓瘡發生率之專案。護理雜誌.附冊，58(3)，56-63。new window  延伸查詢new window
3.Edsberg, L. E.、Black, J. M.、Goldberg, M.、McNichol, L.、Moore, L.、Sieggreen, M.(2016)。Revised national pressure ulcer advisory panel pressure injury staging system: Revised pressure injury staging system。Journal of Wound Ostomy & Continence Nursing，43(6)，585-597。  new window
4.李文怡、藺寶珍、翁嘉杏、林怡伶、蔡紋苓(20120600)。降低長時間俯臥手術病人臉部壓瘡發生率之專案。護理雜誌，59(3)，70-78。new window  延伸查詢new window
5.陳妮婉、張彩秀、張素惠(20130400)。護理人員壓瘡預防行為之系統性文獻查證。澄清醫護管理雜誌，9(2)，40-47。  延伸查詢new window
6.黃微真、張秀如、唐琦敏(20140400)。降低兒童外科加護病房壓瘡發生密度。護理雜誌.附冊，61(2)，60-67。new window  延伸查詢new window
7.蔡秀敏、鄭靜瑜、劉淑如(20111200)。護理敏感品質指標介紹--以美國護士協會及國家品質論壇為例。領導護理，12(3)，95-101。  延伸查詢new window
8.Armstrong, D. G.、Ayello, E. A.、Capitulo, K. L.、Fowler, E.、Krasner, D. L.、Levine, J. M.、Smith, A. P.(2008)。New opportunities to improve pressure ulcer prevention and treatment: implications of the CMS inpatient hospital care present on admission indicators/hospital-acquired conditions policy: A consensus paper from the International Expert Wound Care Advisory Panel。Advances in Skin & Wound Care，21(10)，469-478。  new window
9.Bauer, K.、Rock, K.、Nazzal, M.、Jones, O.、Qu, W.(2016)。Pressure Ulcers in the United States' Inpatient Population From 2008 to 2012: Results of a Retrospective Nationwide Study。Ostomy Wound Management，62(11)，30-38。  new window
10.Beeckman, D.、Schoonhoven, L.、Fletcher, J.、Furtado, K.、Heyman, H.、Paquay, L.、Defloor, T.(2010)。Pressure ulcers and incontinence-associated dermatitis: effectiveness of the Pressure Ulcer Classification education tool on classification by nurses。BMJ Quality and Safety，19(5)，e3。  new window
11.Jankowski, I. M.、Nadzam, D. M.(2011)。Identifying gaps, barriers, and solutions in implementing pressure ulcer prevention programs。The Joint Commission Journal on Quality and Patient Safety，37(6)，253-264。  new window
12.Norman, J.(2012)。A systematic review of the literature on simulation in nursing education。The ABNF Journal，23(2)，24-28。  new window
13.Worsley, P. R.、Clarkson, P.、Bader, D. L.、Schoonhoven, L.(2016)。Identifying barriers and facilitators to participation in pressure ulcer prevention in allied healthcare professionals: A mixed methods evaluation。Physiotherapy，103(3)，304-310。  new window
14.Brown, John Seely、Collins, Allan、Duguid, Paul(1989)。Situated Cognition and the Culture of Learning。Educational Researcher，18(1)，32-42。  new window
15.Strand, T.、Lindgren, M.(2010)。Knowledge, attitudes and barriers towards prevention of pressure ulcers in intensive care units: A descriptive cross-sectional study。Intensive & Critical Care Nursing: The Official Journal of the British Association of Critical Care Nurses，26(6)，335-342。  new window
圖書
1.National Pressure Ulcer Advisory Panel、European Pressure Ulcer Advisory Panel、Pan Pacific Pressure Injury Alliance、Haesler, Emily(2014)。Prevention and Treatment of Pressure Ulcers: Quick Reference Guide。Perth：Cambridge Media。  new window
其他
1.(2011)。加護綜合照護，http://tcpi.tjcha.org.tw/tcpi/。  延伸查詢new window
2.國立臺灣師範大學教學發展中心(20150928)。即時反饋系統，讓教室動起來！，https://ctld.ntnu.edu.tw/%E6%95%99%E7%99%BC%E9%9B%BB%E5%AD%90%E5%A0%B1/1516。  延伸查詢new window
3.Agency for Healthcare Research and Quality(2014)。Preventing Pressure Ulcers in Hospitals，http://www.ahrq.gov/professionals/systems/hospital/pressureulcertoolkit/putool7b.html， 。  new window
4.Institute for Healthcare Improvement(2011)。How-to Guide: Prevent Pressure Ulcers，http://www.ihi.org/resources/Pages/Tools/HowtoGuidePreventPressureUlcers.aspx。  new window
5.Institute for Healthcare Improvement(2017)。How to improve pressure ulcers，http://www.ihi.org/resources/Pages/HowtoImprove/default.aspx。  new window
6.National Pressure Ulcer Advisory Panel(2008)。NPUAP Pressure Ulcer Stages，http://www.npuap.org/pr2.htm。  new window
7.National Pressure Ulcer Advisory Panel(2016)。NPUAP Pressure Injury Stages，http://www.npuap.org/resources/educational-and-clinical-resources/npuappressure-injury-stages/， 。  new window
8.Stein, D.(1998)。Situated Learning in Adult Education，http://ericae.net/edo/ed418250.htm。  new window
 
 
 
 
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