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題名:提昇護理人員執行剖腹產臨床路徑之完整率
書刊名:長庚護理
作者:蕭嘉琪朱苓珍廖姿婷邱燕甘李素宏武佳縈
作者(外文):Hsiao, Chia-chiChu, Ling-chenLiao, Chi-tingChiou, Yen-ganLee, Su-hungWu, Chia-ying
出版日期:2006
卷期:17:4=56
頁次:頁455-465
主題關鍵詞:剖腹產臨床路徑完整率Caesarean sectionClinical pathwayCompleteness
原始連結:連回原系統網址new window
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臨床上常遇到剖腹產個案於出院時,詢問如何執行傷口照護?何時可以開始執行性生活?護理人員若未能即時依據剖腹產個案需求提供適切之衛教內容,將影響個案返家後的自我照顧能力。本專案係針對護理人員執行剖腹產臨床路徑之缺失加以改善。經現況分析後發現其缺失原因為:「剖腹產臨床路徑」表內容完整率偏低僅39.9%、剖腹產臨床路徑衛教項目及衛教單張不一致、欠缺剖腹產臨床路徑表單補充流程、缺乏剖腹產臨床路徑監控流程、護理人員對剖腹產臨床路徑執行方法不一致、護理人員對剖腹產臨床路徑平均認知程度低,僅61.3%。針對上述缺失擬定改善對策:1.修訂「剖腹產臨床路徑」表內容。2.製作「剖腹產照護-產婦篇」衛教單張。3.製訂剖腹產臨床路徑表單補充流程。4.製訂剖腹產照護臨床路徑監控流程。5.製作剖腹產臨床路徑照護指引。6.舉辦剖腹產臨床路徑效益與應用說明會。經改善措施實施後,護理人員執行剖腹產臨床路徑之完整率由39.9%提昇至73.1%、護理人員對剖腹產臨床路徑平均認知程度由61.3%提升至95.9%,均達專案目的,顯示透過完善的臨床路徑規劃及落實臨床護理指導,確實能提升病患照護品質。
Upon being discharged, postpartum women often asked questions about “how do I care the wound?” or “when may we start sexual behavior?” Insufficient instruction often affected the quality of home care. The purpose of this project was to improve the incompleteness of performing Caesarean section (C/S) clinical pathway. After clinical analysis, the content completion rate was only 39.9%. The major factors of the incompleteness were inappropriate time schedule, inconsistency between nursing instruction in clinical pathway and health education materials, shortage of the clinical pathway sheets, lack of continuous monitoring, deficiency of nursing recognition about clinical pathway, and discordant performance of clinical pathway. In order to resolve the problems, methods included revising the content of clinical pathway, developing the nursing instruction sheets for C/S postpartum women care, establishing supplementary procedure, monitoring process and nursing care guidelines for C/S clinical pathway, and holding seminar to introduce the benefits and applications of the pathway. The results indicated that the completeness of C/S clinical pathway performed by nurses increased from 39.9% to 73.1%. Moreover, the nurses?recognition of clinical pathway improved from 61.3% to 95.9%. The goals of the project were successfully achieved. The quality of patient care could also be improved.
期刊論文
1.廖美南、盧美秀(19971000)。臨床路徑之建構。護理雜誌,44(5),29-33。new window  延伸查詢new window
2.張朝凱、楊長興(20010600)。淺談「臨床路徑」。臺灣醫界,44(6),35-36。  延伸查詢new window
3.陳建如、曾惠明、鄭錦翔(20011200)。臨床路徑使用於卵巢或輸卵管卵巢切除術:連續實施十二個月的描述性分析。醫院,34(6),14-21。  延伸查詢new window
4.林宛儀、周恬弘、黃勝雄(20021000)。從病患滿意度的角度探討臨床路徑實施成效--以某區域醫院為例。醫院,35(5),34-43。  延伸查詢new window
5.酈欽菁、蔡秀鸞、葉炳強、蘇慧芳(20020900)。缺血性腦中風臨床路徑之成效。臺灣醫學,6(5),672-681。  延伸查詢new window
6.王琦、廖梅珍(2001)。經腹腔鏡卵巢切除術臨床路徑實施之成效。長庚護理,12(1),23 – 29。new window  延伸查詢new window
7.周守民、顏妙芬(2002)。資訊時代中的臨床路徑發展。台灣醫學,6(1),251-255。  延伸查詢new window
8.卓妙如、陳佳鳳、趙宏明(2001)。臨床路徑照護流程及成效探討以小兒腹股溝疝氣修補術為例。領導護理,4(2),37-44。  延伸查詢new window
9.徐南麗、賴正芬、謝美玲、廖惠娥、林碧珠(2002)。比較實施臨床路徑前後之護理品質。慈濟護理雜誌,1(2),77-86。  延伸查詢new window
10.翁新惠(2000)。臨床路徑於醫療照護管理之應用。榮總護理,17(3),215-222。new window  延伸查詢new window
11.陳麗梅、吳佩芬、蕭麗珠、江玲玲、黃秀雲(1998)。運用臨床路徑提昇剖腹產照護品質。秀傳醫學雜誌,1(l),21 - 33。  延伸查詢new window
12.彭麗蓉、陳秋鶯(2002)。臨床路徑在護理業務上的應用。秀傳醫學雜誌,3(2-3),65-69。  延伸查詢new window
13.鄧素文(1997)。臨床路徑的發展與建立一以某醫學中心自然生產發展經驗為例。護理雜誌,44(5),34- 40。new window  延伸查詢new window
14.鍾玉珠、呂淑芬(2004)。衛教對剖腹產患者其術前焦慮及護理滿意度之成效探討。新臺北護理期刊,6(2),63 -71。  延伸查詢new window
15.Brownell, K. K., Hutton, L. Hartman, J.,、Dabrow,S.(2002)。Barrier to breast feeding amongAfrican American adolescent mothers。Clinical Pediatrics,41(9),669-673。  new window
16.Bookbinder, M., Blank, A. E., Arney, E., Wollner,D., Lesage, P. McHugh, M., et al.(2005)。Improving end-of-life care: development andpilot-test of a clinical pathway。Journal Article,Journal of Pain and Symptom Management,29(6),529-543。  new window
17.Chan, S. M., Nelson, E. A.,、Leung, S. S.(2000)。Breast feeding failure in longitudinal postpartum maternal nutrition study in Hong kong。Journal of Pediatrics & Child health,36(5),466-7 1。  new window
18.Kinsman, L.(2004)。Clinical pathway compliance and quality improvement。Nursing Standard,18(18),33-35。  new window
19.Okon, T. R., Evans, J. M., Gomez, C. F.,、Blackhall, L. J.(2004)。Palliative educational outcome with implementation of PEACE Tool integrated clinical pathway。Journal of Palliative Medicine,7(2),279-295。  new window
圖書論文
1.張瑞莉(2001)。分娩婦女併發症的護理。最新婦產科護理。台北:匯華。  延伸查詢new window
 
 
 
 
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