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監測輔助工具對加護病房護理人員敗血症照護認知與行為成效之探討

Exploration of Sepsis Monitoring-Assisted Tool on Cognition And Behavior Efficacy of Intensive Nursing Staffs.

作者:洪慈婉
畢業學校:慈濟大學
出版單位:慈濟大學
核准日期:2012-10-15
類型:Electronic Thesis or Dissertation
權限:Copyright information available at source archive--Tzu Chi University....

中文摘要

敗血症是全世界關注議題,也是加護病房患者常見的死亡原因之一,而敗血症的治療關鍵,在於臨床醫護人員對重點監測指標掌握的黃金時間與準確程度。過去國內外探討臨床內科加護病房護理人員,對敗血症重點監測指標之認知與教育介入後的成效研究較少。因此,本研究的目的在於運用常規教育訓練介入後,再以簡易敗血症指標評估目標圖作為護理人員之臨床評估工具,藉以探討護理人員對敗血症重點監測之認知成效。本研究採用實驗研究設計及方便取樣方式,研究期間於 2012 年 02 月至 2012 年 05 月,以東部某醫學中心二個內科加護病房為取樣地點,共邀請 59 人參與研究,其中有 9 人未能完成三次的後續研究,流失率為 15%,故本研究實際完成三次研究對象為實驗組 24 人和對照組 26 人,研究樣本數共 50 人。實驗組給予教育訓練及重點監測指標雷達圖介入,而對照組僅給予教育訓練。研究工具以研究者自擬的結構式問卷,共三個部分包括護理人員背景資料、敗血症患者重點監測指標認知與行為量表,以及重點監測指標雷達圖。資料收集及步驟為研究開始前先以認知量表進行前測,進行教育訓練後再進行中測,而兩組分別在實驗組以重點監測指標雷達圖工具介入 4 週後再進行一次後測。研究數據預計以編碼並輸入電腦,以 SPSS for windows 14.0 統計軟體進行資料建檔及統計分析。研究結果及發現 1.加護病房護理人員在教育訓練介人後,對於敗血症重點監測指標知識,有顯著效果(p <0.01)。2. 加護病房護理人員使用重點雷達圖監測輔助工具,對於認知延續之成效較傳統護理評估介入佳(p<0.05)。3. 加護病房護理人員教育訓練介入後在行為得分上無特殊差異。4. 加護病房護理人員基本屬性中,在最近一年內有參與敗血症相關課程或研習會,以及有修過重症課程,對於敗血症重點監測指標知識增加確實有明顯的效果(p<0.05)。研究結論為加護病房護理人員接受教育訓練課程其短期之敗血症認知提升是有顯著效果,合併使用重點雷達圖監測輔助工具,其敗血症認知廷續性較傳統護理評估介入佳。護理人員是第一個評估到危急指標的人員,因此護理人員具備專業知識與技能是重要啟動因子,若有一套簡易的評量工具的確可以提升護理人員對敗血症重點監測指標的敏感度,就能夠逹到早期發現早期治療的目的。

英文摘要

The public health issue about septic patients is currently an important one because of the high
incidence and mortality rate of severe sepsis in the intensive care unit (ICU).The key point in the
treatment of sepsis is whether the clinical staff sensitivity monitored the sepsis target parameters in the
early phase. In the past, the data in discussing sepsis target parameters education program in medical
intensive nursing staffs is quite insufficient. Therefore, the main aim of this preliminary study is to
explore the cognition and behavior efficacy after a sepsis target parameters education program in
medical intensive nursing staffs. This is a comparative study with purposive sampling in two medical
intensive care units of a hospital centers in eastern Taiwan. The study period was lasted from February,
2012 to May, 2012. We invited 59 people to participate in the study, but there were 9 people failed to
complete the follow-up study, and the wastage rates is 15%.
The sampling include 50 medical intensive nursing staffs in intensive care unit. There were 24
subjects in the experimental group, and 26 subjects in the control group. The experimental group
received a sepsis target parameters education program and use Radar chart- monitoring assisting tools
while the control group received a sepsis education program. The questionnaire of nurses cognition and
behavior were also used in this study. The structured questionnaires of nurses cognition were collected
in both medical and intensive care units before and after sepsis education intervention. After four weeks,
the sepsis target parameters education program only used in control group and experimental group
received a sepsis target parameters and use Radar chart- monitoring assisting tools. And the nurses
cognition and behavior about the sepsis target parameters were collected in both groups. After that, the
collecting data will be input the computer for coding and statistical analysis with 14.0 SPSS windows
software, and get the following results: 1). The sepsis knowledge score after sepsis education was
significantly increased (p <0.01) in medical intensive nursing staffs. 2). The sepsis knowledge score
after sepsis target parameters education program and use Radar chart- monitoring assisting tools was
significantly increased (p 0.05) in medical intensive nursing staffs. 3). The sepsis behavior score after
sepsis target parameters education program did not show significance in medical intensive nursing staffs.
4). The education program had significantly higher the knowledge score about sepsis target parameters
education program during year and Critical Care Elective. And the conclusion is: the sepsis target
parameters education can increase intensive care unit nurses' sensitivity and awareness of sepsis signs
and symptoms, and it will increase the effectiveness in using Radar chart- monitoring assisting tools.
Furthermore, we expect to increase the effectiveness of sepsis target parameters monitoring, and
enhance the quality of care with intensive care units patients in the near future.


口試委員 - 黃寒裕

指導教授 - 怡懋.蘇米

召集人 - 羅淑芬


 

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