提升初次血液透析門診病人護理指導滿意度

病人服務滿意度是臨床病人照護面及護理品質的重要指標項目之一。調查2019年8-10月共13位初次血液透析門診病人，護理指導滿意度僅有3.32分。分析原因為：護理指導工具不符合現況所需、護理指導方法不夠多元化、缺乏完善的護理指導作業標準流程規範。故選定八項改善方案：（1）舉辦護理指導方法教育訓練；（2）修訂護理指導作業標準流程；（3）制定護理指導作業稽核方法；（4）修訂護理指導單張；（5）錄製血液透析護理指導相關影片；（6）設立Facebook護理指導群組並建立QR code連結；（7）製作透析用導管傷口及手臂動靜脈瘻管模型；（8）使用透析飲食紅綠燈認知測驗盤進行飲食認知評值。經專案措施介入後，初次血液透析門診病人護理指導滿意度由3.32分提升至4.46分，達成專案目的。希望藉由專案分享，完善的護理指導措施介入，幫助初次血液透析門診病人自我照顧能力的增加，提升最佳透析生活品質。  Patient satisfaction is one of the important indicators of clinical patient care and nursing quality. A survey filled out by 13 outpatients who underwent their first hemodialysis during the period of August to October 2019 indicated that satisfaction with nursing guidance was only 3.32 points. The reasons included the following: the nursing guidance tools did not meet the needs of current situations, the nursing guidance methods were not diversified enough, and the lack of a completely standardized operating procedure for nursing guidance. Therefore, eight improvement plans were selected: (1) to hold nursing guidance method educational trainings, (2) to revise the standard operating procedure of nursing guidance work, (3) to develop nursing guidance audit methods, (4) to revise nursing guidance leaflets, (5) to record videos relating to hemodialysis nursing guidance, (6) to establish a Facebook nursing guidance group and create a QR code link, (7) to make hemodialysis catheter wounds and arm arteriovenous fistula models, (8) to use hemodialysis diet traffic light cognitive test panel for diet cognition evaluation. After the implementation of the measures, the satisfaction of outpatients’ care guidance for those undergoing their first hemodialysis increased from 3.32 points to 4.46 points, thus fulfilling the purposes of the project. It is hoped that through the sharing of the project and the implementation of comprehensive nursing guidance measures, it will help outpatients undergoing their first hemodialysis increase their self-care ability and improve quality of hemodialysis life.