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題名:以實證護理提升護理人員執行腦中風病人吞嚥評估之精確度
書刊名:長庚護理
作者:莊情惠陳柏成梁秋萍林淞坊
作者(外文):Chuang, Ching-huiChen, Po ChengLeong, Chau-pengLin, Sung-fang
出版日期:2017
卷期:28:3=99
頁次:頁426-438
主題關鍵詞:實證護理腦中風吞嚥評估Evidence-based nursingStrokeSwallowing assessment
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(0) 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:0
  • 共同引用共同引用:9
  • 點閱點閱:3
背景:吞嚥評估是護理人員照護腦中風病人很重要的能力,復健科病房2014 年腦中風病人併發吸入性肺炎發生率為2.59‰。目的:專案主旨為提升護理人員執行腦中風病人吞嚥評估之精確度。方法:現況發現護理人員之吞嚥評估認知正確率42.7% 與護理人員之吞嚥評估執行精確度為4.75%。專案內容包括實施腦中風病人吞嚥評估實證文獻資料查詢,訂定吞嚥評估實施流程、製作吞嚥評估實施標準、舉辦吞嚥評估在職教育課程與操作一致性稽核。結果:經專案改善後,護理人員之吞嚥評估認知正確率由42.7% 提高至100%、護理人員對吞嚥評估執行精確度由4.75% 提高至100%,腦中風病人併發吸入性肺炎發生率由2.59‰下降至1.36‰。結論:護理人員可應用實證護理於臨床工作中,以提升腦中風病人吞嚥評估之精確度,最終能造福腦中風吞嚥困難病人,也能提升護理專業形象與專業能力。
Background: The ability of nursing staff to determine stroke deglutition disorders is important in care of stroke patients. The incidence rate in 2014 had revealed that aspiration pneumonia among patients with stroke was 2.59‰ in the rehabilitation ward. Purpose: This study aimed to increase diagnostic accuracy of stroke deglutition disorders among nursing staff in stroke care. Method: An investigation revealed that the knowledge of swallowing assessment among nursing staff was 42.7%, and the diagnostic accuracy of stroke deglutition disorders made by nursing staff was 4.75%. Solutions included query empirical literature, revised the policy for standard care for swallowing assessment, procedures, provided continuing education courses regarding swallowing assessment and audited the operational consistency. Results: After implementing strategies for these projects. Nursing staffs' knowledge of swallowing assessment improved from 42.7% to 100%. The diagnostic accuracy of stroke deglutition disorders made by nursing staff increased from 4.75% to 100%, and the incidence of aspiration pneumonia among patients with strokedecreased from 2.59‰ to 1.36‰. Conclusion: By applying evidence-based nursing to clinical practice, nursing staff can increase diagnostic accuracy of stroke deglutition disorders, patients with stroke deglutition disorders can be treated promptly and effectively, and the professional image as well as ability of nursing staff can also be boosted.
期刊論文
1.何怡慧、劉秀月、黃純德(20140400)。復建期腦中風病患咀嚼吞嚥障礙盛行率及初步篩檢徵象之探討。護理雜誌,61(2),54-62。new window  延伸查詢new window
2.Daniels, S. K.、Anderson, J. A.、Willson, P. C.(2012)。Valid items for screening dysphagia risk in patients with stroke: A systematic review。Stroke,43(3),892-897。  new window
3.Brogan, E.、Langdon, C.、Brookes, K.、Budgeon, C.、Blacker, D.(2014)。Dysphagia and factors associated with respiratory infections in the first week post stroke。Neuroepidemiology,43(2),140-144。  new window
4.Wilson, R. D.、Howe, E. C.(2012)。A cost-effectiveness analysis of screening methods for dysphagia after stroke。PM&R: Physical Medicine and Rehabilitation,4(4),273-282。  new window
5.Warnecke, T.、Teismann, I.、Meimann, W.、Olenberg, S.、Zimmermann, J.、Krämer, C.、Ringelstein, E. B.、Schäbitz, W. R.、Dziewas, R.(2008)。Assessment of aspiration risk in acute ischaemic stroke: Evaluation of the simple swallowing provocation test。Journal of Neurology, Neurosurgery & Psychiatry,79(3),312-314。  new window
6.Pasha, S. F.、Acosta, R. D.、Chathadi, K. V.、Chandrasekhara, V.、Decker, G. A.、Early, D. S.、Cash, B.(2014)。The role of endoscopy in the evaluation and management of dysphagia。Gastrointestinal Endoscopy,79(2),191-201。  new window
7.陳柏成、莊情惠(20150600)。腦中風吞嚥困難病人吞水測驗精確度之統合分析。護理暨健康照護研究,11(2),161-169。new window  延伸查詢new window
8.Jauch, E. C.、Saver, J. L.、Adams, H. P. Jr.、Bruno, A.、Connors, J. J.、Demaerschalk, B. M.、Yonas, H.(2013)。Guidelines for the early management of patients with acute ischemic stroke a guideline for healthcare professionals from the American Heart Association/American Stroke Association。Stroke,44(3),870-947。  new window
9.González-Fernández, M.、Daniels, S. K.(2008)。Dysphagia in stroke and neurologic disease。Physical Medicine and Rehabilitation Clinics of North America,19(4),867-888。  new window
10.Trapl, M.、Enderle, P.、Nowotny, M.、Teuschl, Y.、Matz, K.、Dachenhausen, A.、Brainin, M.(2007)。Dysphagia bedside screening for acute-stroke patients: the Gugging Swallowing Screen。Stroke,38(11),2948-2952。  new window
11.Ramsey, D.、Smithard, D.、Kalra, L.(2005)。Silent aspiration: what do we know?。Dysphagia,20(3),218-225。  new window
圖書
1.連倚南、洪章仁、賴金鑫、王顏和、王亭貴、畢柳鶯、謝霖芬(2013)。復健醫學。臺北市:合記圖書出版社。  延伸查詢new window
 
 
 
 
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