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題名:腰椎穿刺檢查後病人平躺舒適度之改善專案
書刊名:長庚護理
作者:金瑞美王筱媖蔡惠萍陳雅玲陳芷萱陳虹如
作者(外文):Chin, Jui-meiWang, Hsiao-yingTsai, Hui-pingChen, Ya-lingChen, Chih-hsuanChen, Hung-ju
出版日期:2018
卷期:29:2=102
頁次:頁235-247
主題關鍵詞:腰椎穿刺檢查舒適度穿刺後頭痛Lumber puncture examinationComfortPost-dural puncture headache
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(0) 博士論文(0) 專書(0) 專書論文(0)
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  • 共同引用共同引用:7
  • 點閱點閱:4
腰椎穿刺檢查為診斷中樞神經系統感染常見檢查,藉由抽取少量的腦脊髓液檢查或引流多餘的腦脊髓液,以達到疾病診斷和測量腦壓為目的。檢查後必須採平躺姿勢6至8小時,且頭部不可睡枕頭,以免造成頭痛的後遺症,然而此種姿勢讓病人感到肩頸腰背酸痛和解尿困難等不舒適問題,影響了病人平躺意願。經調查發現:護理人員未能主動評估及介入處理病人腰背酸痛問題、缺乏病人臥床期間的活動指引和合適的翻身輔具,因而造成所有腰椎穿刺檢查後病人均抱怨持續平躺的不適。藉由修訂腰椎穿刺檢查後護理照護標準、籌劃在職教育、挑選購置合適的枕頭和翻身輔具及制定腰椎穿刺檢查後病人平躺舒適監測指標等方案後,提升腰椎穿刺檢查後病人平躺舒適度至94.1%,達到專案目標,對臨床護理工作有顯著幫助,並提升照護品質。
Lumbar puncture is a common examination for diagnosis of infection of central nervous system. During the examination, some cerebrospinal fluid is extracted and the redundant cerebrospinal fluid is drained. After the examination, the patients must lie on the back for 6 to 8 hours, and a pillow is not allowed during the period to avoid the sequelae of headache. However, such a posture often makes the patients uncomfortable, causing aching shoulders, neck, waist, and back as well as difficult urination, which reducing the patients' willingness to lie on the back. According to the investigation, lack of caregivers' active evaluation of and solutions to the aching waist and back of the patients, and lack of guidance for the activities after the examination, and lack of appropriate turn-over tools resulted in discomfort of lying on the back after examination. After establishing the care standards post-lumber puncture examination, planning an in-service education, providing appropriate pillows and turn-over tools, and creating indexes of monitoring the comfort level of lying on back, the comfort of the patients increased to 94.1%, reaching the objective of the project. The project provides a useful reference for improving the quality of clinical care.
期刊論文
1.Devitt, J.、Shellman, L.、Gardner, K.、Nichols, L. W.(2011)。Using positioning after a colonoscopy for patient comfort management。Gastroenterology Nursing,34(2),93-100。  new window
2.Thiadens, T.、Vervat, E.、Albertyn, R.、van Dijk, M.、Van As, A. B.(2011)。Evaluation of pain incidence and pain management in a South African paediatric trauma unit。South African Medical Journal,101(8),533-536。  new window
3.蔡佳玲、李雅玲、胡文郁(20120200)。舒適之概念分析。護理雜誌,59(1),77-82。new window  延伸查詢new window
4.林利珍(20100500)。運用資訊結合實證文獻於臨床護理照護。源遠護理,4(1),5-10。  延伸查詢new window
5.黃郁蕙、陳清惠(20100400)。緩解經皮冠狀動脈介入治療後背痛之照護經驗。護理雜誌,57(2附冊),75-80。new window  延伸查詢new window
6.陳明珠(2004)。腰椎穿刺標準作業流程。北市醫學雜誌,1(4),168-170。  延伸查詢new window
7.蘇育瑱、吳麗敏(20140100)。應用舒適理論於一位高齡婦女之照護經驗。馬偕護理雜誌,8(1),76-84。  延伸查詢new window
8.楊春穎(20110300)。脊髓麻醉術後平躺時間之實證評讀。榮總護理,28(1),32-38。new window  延伸查詢new window
9.Thoennissen, J.、Herkner, H.、Lang, W.、Domanovits, H.、Laggner, A.、Mullner, M.(2001)。Does bed rest after cervical or lumbar puncture prevent headache? A systematic review and meta-analysis。Canadian Medical Association of Journal,165(10),1311-1316。  new window
10.Sudlow, C.、Warlow, C.(2009)。Posture and fluids for preventing post-dural puncture headache (Review)。The Cochrane Library,1,1-31。  new window
11.Rodriguez, L. A.、Ciapponi, A.、Munoz, L.、Roquei, F.、Bonfill, C.(2013)。Posture and fluids for preventing post-dural puncture headache (Review)。The Cochrane Collaboration in the Cochrane Library,12(7),CD009199。  new window
12.Kim, S. R.、Chae, H. S.、Yoon, M. J.、Han, J. H.、Cho, K. J.、Chung, S. J.(2012)。No effect of decumbency duration on the occurrence of post-lumbar puncture headache with a 22G cutting needle。Bio Med Central Neurology,12(1),1471-2377。  new window
13.Williams, J.、Lye, D.(2008)。Diagnostic lumbar puncture: minimizing complications。Internal Medicine Journal,38(7),587-591。  new window
其他
1.蔡佩珊(2010)。半身麻醉,http://www.hc.mmh.org.tw/ knowledge/knowledge_Detail.asp ? Csdp=7581&Writing_No=80。  new window
圖書論文
1.馮容芬(2016)。神經系統疾病之護理。成人內外科護理。台北:華杏。  延伸查詢new window
2.陳朝鈞(2006)。下背痛的物理治療檢查。下背痛徒手物理治療導論。台北:合記。  延伸查詢new window
 
 
 
 
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