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題名:照護一位車禍多重骨折術後病人之護理經驗
書刊名:長庚護理
作者:林鈺嫺蘇家[糹柔]胡瑞桃
作者(外文):Su, Jia-rouHu, Shui-tao
出版日期:2018
卷期:29:2=102
頁次:頁282-293
主題關鍵詞:多重性骨折車禍術後病人Multiple fracturesAccidentPost surgery patient
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:21
  • 點閱點閱:2
本篇報告主要探討一位19歲女性,因酒後機車車禍四肢開放性骨折,於2015年7月1日緊急進行雙側股骨切開復位外固定及霍夫曼固定術,7月4日至8月12日於骨科病房照護期間,個案及家屬面對突發的意外,極度擔心疾病進展及預後等相關問題,引發撰寫此報告之動機。期間運用傾聽、會談、角色參與及身體評估等資料收集,採用Gordon功能性健康型態十一項進行評估,個案依序有急性疼痛、身體活動功能障礙及焦慮等健康問題。醫療團隊積極提供個別性照護措施,包括指導個案術後疼痛控制方法、協助肢體活動擺位、協助增進身體舒適度、安排醫師告知病情進展和術後復健進度等相關照護措施。個案於照護期間,疼痛改善、於家屬陪同下積極參與復建治療、對病情進展的瞭解降低焦慮,最後個案病情穩定於8月12日轉至復健科繼續治療,8月25日順利出院。經由個案同意出院後電訪得知,個案出院後可獨立執行相關日常生活,一個月後返回最愛的咖啡廳吧檯就業。建議照護多重性骨折病人時,術後透過跨團隊會議,與個案/家屬共同擬訂術後復健及出院照護計畫,同時以復健照護日程表呈現,住院期間個案/家屬依日程表參與復健,並依個案復健進展調整復健進度,於出院前再進行評估追蹤個案完成復健狀況及衛教指導改善,以利個案出院後能自我照顧。希望藉此經驗分享,提供日後臨床照護之參考。
The report described the nursing experience of caring a 19-year-old girl with multiple open fractures on limbs due to a drunk-riding motorcycle accident. The patient received bilateral femoral open external reduction and Hoffman fixation on July 1, 2015. The patient and her families faced the unexpected accident, expressing extreme worry about the progression and prognosis of the injury. The nursing period was from July 4 to August 12, 2015. Using the 11 Gordon functional health assessments tool, data were collected by listening, interview, role participation, and physical examination. Three major health problems were identified, including acute pain, impaired physical mobility, and anxiety. Based on the identified health problems, the medical team provided necessary care, including education about the postoperative pain control method, assistance of physical activities placement, assistance of improving physical comfort, arrangement of doctors updating the disease progression, and provision of postoperative rehabilitation program. After discharge, the patient could perform daily activities independently. In addition, the patient returned to her favorite coffee bar working after a month. The health care team provided patients and her family memberswith the postoperative rehabilitation and discharge care plans to facilitate participation. At the same time, the patient and her family members followed the daily rehabilitation care schedule and adjusted the plan timely based on status of the patient. Before being discharged, the patient was assessed to ensure self-care ability after discharge. The results of this nursing experience provides a reference for caring patients with multiple fractures.
期刊論文
1.安豐娟、林靜娟、劉波兒(20080400)。照顧一位頭部外傷術後患者及其家屬之護理經驗。弘光學報,52,37-46。new window  延伸查詢new window
2.Kelly, M.、Dowling, M.(2008)。Patient rehabilitation following lower limb amputation。Nursing Standard,22(49),35-40。  new window
3.胡文郁、陳宛榆、羅淑芬、陳書毓、黃翰心、陳幼貴(20111200)。成人癌症疼痛臨床照護指引。腫瘤護理雜誌,11(增刊),87-127。  延伸查詢new window
4.徐莞雲、陳筱瑀(20080600)。焦慮的概念分析。志為護理,7(3),65-70。  延伸查詢new window
5.靳燕芬(20070600)。傷口換藥疼痛護理。護理雜誌,54(3),87-91。new window  延伸查詢new window
6.鄭佩芬、柯貞如(20120600)。照顧一位骨折創傷後膝上截肢患者的護理經驗。志為護理,11(3),119-128。  延伸查詢new window
7.Walker, J.(2009)。Spinal cord injuries: Acute care management and rehabilitation。Nursing Standard,23(42),47-56。  new window
8.李秋璇、廖玟君(20110900)。照護一位頭部外傷青少年病患之護理經驗。Chung Shan Medical Journal,22(3),341-348。  延伸查詢new window
9.李雅雪(20071100)。照護一位多處骨折病患之復健護理經驗。高雄護理雜誌,24(2),30-46。  延伸查詢new window
10.徐逸芬、王慧瑜、江惠貞、陳蘭蕙、楊麗玉(20100900)。照顧一位肺癌骨轉移患者行人工髖關節置換術之護理經驗。弘光學報,60,34-45。new window  延伸查詢new window
11.焦雅芳(20090200)。照護一位拒絕右手腕下截肢個案之護理經驗。新臺北護理期刊,11(1),103-111。  延伸查詢new window
12.林筱芳、林惠霜(20120300)。照顧一位面臨截肢壓力出現自殺企圖患者之經驗。臺灣腎臟護理學會雜誌,11(1),85-98。  延伸查詢new window
13.陳靜怡、謝春金(20140400)。照護一位嚴重創傷合併雙下肢截肢個案之護理經驗。志為護理,13(2),81-90。  延伸查詢new window
14.楊千慧(2010)。一位青少年因多重外傷導致身體心象紊亂之照顧經驗。高雄護理雜誌,27(1),49-59。  延伸查詢new window
15.蔣昀孜、孫美華、任秀崎(20090600)。照護一位青少年車禍創傷後身體心像紊亂之護理經驗。亞東學報,29,257-266。  延伸查詢new window
16.Santy, J.(2000)。Nursing the patient with an external fixator。Nursing Standard,19(14),47-52。  new window
研究報告
1.衛生福利部(2013)。2012生命統計主要死因統計。  延伸查詢new window
學位論文
1.俞泰華(2012)。行人與機車騎士下肢碰撞模擬及傷害評估(碩士論文)。國立成功大學。  延伸查詢new window
2.蕭丞瑋(2014)。應用於行人及機車騎士安全評估之機械下肢實體設計(碩士論文)。國立成功大學。  延伸查詢new window
圖書
1.Carpenito, L. J.(2000)。Nursing diagnosis。  new window
其他
1.Karl, B. F.(2011)。Overview of tibial fracture in adults,http://www.uptodate.com/contents/overview-of-tibial-fractures-inadults?source=search_result&search=tibia+fracture&selectedTitle=1%7E26。  new window
圖書論文
1.林笑、吳翠娥、李和惠、邱飄逸(2013)。骨骼、肌肉、關節疾病病人之護理。內外科護理學。臺北:華杏。  延伸查詢new window
 
 
 
 
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