泌尿道癌症術後延遲下床之原因分析
-以南臺灣某醫學中心為例
莊惠娟1 、黃冠華2、楊惠鈺3、許芳華3
奇美醫學中心外科部泌尿科專科護理師1、奇美醫學中心外科部泌尿腫瘤外科2、
奇美醫學中心護理部3
Analysis on post-operative delayed-ambulation patient after genitorurinary tract carcinoma- a medical center hospital based study in southern taiwan
Hui Juan Zhuang1, Steven Kuan-Hua Huang2, Hui-Yu Yang3, Fang-Hua Hsu3
Nurse Practitioner in Urology Department of Surgery Chi Mei Medical Center1, Division of Urological Oncology, Department of Surgery Chi Mei Medical Center2, Nursing Department Chi Mei Medical Center3
Purpose:
Early bed prone to Genitorurinary Tract Carcinoma surgery patients with pneumonia, intestinal obstruction, thrombophlebitis of lower extremities and other complications, and postoperative recovery delays and increased costs. Therefore the accomplished goal of this improvement proposal is to decrease the delayed-ambulation rate from 80% to 50%. Understanding postoperative bed and cause poor performance, as the preventive measures of postoperative Genitorurinary Tract Carcinoma patients and rehabilitation exercise plan.
Method:
A retrospective study was used to collect data about Genitorurinary Tract Carcinoma surgery patients from a medical center in southern Taiwan. Self-designed checklists from January 2014 to December 2015, District a total of 300 passengers, the main data source to postoperative delayed bed and the consolidation of patients with a total of 240 people, descriptive analysis was performed and presented for classification variables including number of distribution and percentage, as well as continuous variables such as mean, standard deviation .
Results:
Three hundred Genitorurinary Tract Carcinoma surgery patients were record .Two hundred forty representing a rate of 80 Delayed-Ambulation per 100 patient visits. The average age was 66 years and a median of 66.3% were men (n = 199), patients ≥ 65 years 168 visitors (56%), average length of stay of eleven days in table 1. Problems caused delays getting out of bed after one hundred forty-eight subjects to pain factor (49.3%) bloating issue Twenty-nine subjects (9.6%); pneumonia Twenty-one subjects (7%), thrombophlebitis one subject (0.03%) at least in figure 1.
Conclusion:
Using resources integration concept, collection urinary surgical patients demographic data. From March 2016 according to across field convened medical related team (Complex Health Division, and Nutrition Division, and Urology physician, and nursing Division, and products tube Nursing Division, and specialist nursing Division), draws up in front of the patient technique to prepare the measure together; Postoperative pain, pipe care, postoperative patient assessment steps, timing and getting out of bed rehabilitation programmers, and on the concept and practice of Urology Conference report early out of bed, made Director and physician of urology and CNS consensus and cooperate fully, can reduce the occurrence of postoperative complications and shortening the length of stay, improve quality of care.