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題名:照顧一位創傷性足三踝骨折病人之手術全期護理經驗
書刊名:長庚護理
作者:童雯曾淑慧
作者(外文):Tung, WenTseng, Shu-hui
出版日期:2018
卷期:29:4=104
頁次:頁612-622
主題關鍵詞:急診等候手術創傷性足三踝骨折手術全期護理Waiting for undergoing surgery at the ERTraumatic trimalleolar fracturePerioperative nursing
原始連結:連回原系統網址new window
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  • 共同引用共同引用:7
  • 點閱點閱:2
本文是在敘述一位創傷性足三踝骨折病人,於急診等候接受開放式復位鋼板內固定術之手術全期護理經驗。筆者於2016年02月20日至02月26日護理期間,在手術前、中、後期藉由觀察、傾聽、會談、身體評估及查閱病歷等方式收集資料,並以手術全期照護模式為評估架構,確立個案有焦慮、潛在危險性手術情境的傷害及潛在危險性周邊神經血管功能失常等健康問題。在手術全期護理過程中,筆者藉由主動傾聽與關懷,針對急診等候入手術室之個案的需求,提供手術相關資訊,增進個案對骨折手術及麻醉的了解,減輕手術前期的焦慮;手術中期提供正確擺位及適當防護,以預防不可逆的手術風險發生;並針對骨科手術病人,術後可能發生之神經血管損傷之風險,給予個別性衛教及護理,讓個案在安全舒適之環境下能順利出院。因急診等候手術病人無法完整獲得手術及麻醉相關資訊,易引發焦慮問題,建議護理人員能運用手術前衛教短片或衛教單張,以協助急診等候接受手術病人心理上能更早適應及減輕壓力,進而提升手術照護品質。
This study describes the perioperative nursing experience on a patient with traumatic trimalleolar fracture waiting for undergoing Open Reduction Internal Fixation (ORIF) at the ER. During the nursing period from February 20 to February 26, 2016, the researcher adopted methods of observation, listening, interviews, physical evaluation, and medical chart review. Data were collected before, during, and after the surgery. In addition, perioperative nursing care model was used as the evaluation framework to confirm that the patient experienced health issues, such as anxiety, potential risk for operative injury, and potentially dangerous peripheral neurovascular dysfunction. During the perioperative nursing, the researcher proactively listened to and cared for the patient at the ER waiting for undergoing the surgery by understanding the patient's needs, providing surgery-related information, increasing the patient's understanding of fracture surgery and anesthesia, and reducing the perioperative anxiety. During the surgery, the researcher provided correct positioning and adequate protection information to the patient, in order to prevent the occurrence of irreversible surgical risk. Moreover, for patients undergoing orthopedic surgery, the researcher provided them with individualized health education and potential risk of postoperative neurovascular injury to enable the patient to be discharged from hospital in a safe and comfortable state. Because patients waiting for undergoing surgery at the ER are unable to obtain complete information on surgery and anesthesia, thus may trigger anxiety problems, nursing personnel are advised to use perioperative health education short films or health education leaflet to assist patients waiting for undergoing surgery at the ER in mentally adapt themselves to the surgery and reduce pressure as early as possible to further improve surgical care quality.
期刊論文
1.任秀如(20120500)。手術全期護理。醫療品質雜誌,6(3),27-30。new window  延伸查詢new window
2.黃克勤(20120100)。提升醫療團隊對手術全期照護之完整率。中華科技大學學報,50,215-234。  延伸查詢new window
3.張瑞春、陳懿茹、黃雅莉、陳麗貞、賀倫惠(20120200)。提升急診室護理人員執行手術前護理準備完整性。志為護理,11(1),85-96。  延伸查詢new window
4.李昭憲、楊燦、賴家欣、鄭麗櫻(20140500)。探討骨科患者內固定復位手術前後焦慮感及其相關因素之研究。美和學報,33(1),95-107。  延伸查詢new window
5.黃玉玲、林慧玲、王方、吳淑芳(20151200)。預防手術後壓瘡照護流程之發展。護理雜誌,62(6),98-104。new window  延伸查詢new window
6.洪曉佩、楊淑玲、曾麗華、郭素真、吳祚光、趙瑩惠、明金蓮(20150400)。以質性研究探討接受全身麻醉病人之手術全期經驗。高雄護理雜誌,32(1),4-17。  延伸查詢new window
7.鄧允武、廖浩欽、藍秉文、朱海慶、江旺財、王少谷(20130600)。骨科陷阱。臺灣急診專科醫師期刊,5(2),28-38。  延伸查詢new window
8.Mehta, S. S.、Rees, K.、Cutler, L.、Mangwani, J.(2014)。Understanding risks and complications in the management of ankle fractures。Indian Journal of Orthopaedics,48(5),445-452。  new window
9.Singh, R.、Kamal, T.、Roulohamin, N.、Maoharan, G.、Ahmed, B.、Theobald, P.(2014)。Ankle fractures: A literature review of current treatment methods。Open Journal of Orthopedics,4(11),292-303。  new window
10.蔡東燁、王仁威、李佳霖、邱煥民(20160700)。Severe Pulmonary Embolism Following Operative Treatment of Ankle Fracture: A Rare Case Report and Review of the Literature。Medical Journal of South Taiwan,12(1),48-54。  new window
研究報告
1.衛生福利部統計處(20160520)。民國103年醫療統計年報表14外傷患者門、住診人數統計--按性別及年齡分。  延伸查詢new window
圖書
1.Ralph, Sheila Sparks、Taylor, Cynthia M.、黃靜微、林家綾、喬佳宜、程子芸、林麗秋、郭惠敏、張秉宜(2014)。最新護理診斷手冊:護理計畫與措施。台北:華杏。  延伸查詢new window
2.伍雁鈴、吳秋燕、張玉珠、劉棻(2015)。手術室護理。臺北市:華杏。  延伸查詢new window
3.Rothrock, J. C.、伍雁鈴、何文佑、何嘉倫、李育茹、李則平、李瓊淑(2014)。Alexander手術全期護理--實務基礎。臺北市:台灣愛思唯爾。  延伸查詢new window
 
 
 
 
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