Lin Ruei-Ching, Lin Chia-Huei, Weng Shu-Min, Lin Chi-Feng, Wang Wei-Yun, Tzeng Wen-Chii
BSN, RN, Head Nurse, Department of Nursing, Tri-Service General Hospital, Taiwan, ROC.
PhD, RN, Supervisor, Department of Nursing, Tri-Service General Hospital, Songshan Branch, and Adjunct Assistant Professor, School of Nursing, National Defense Medical Center, Taiwan, ROC.
Hu Li Za Zhi. 2021 Feb;68(1):64-73. doi: 10.6224/JN.202102_68(1).09.
BACKGROUND & PROBLEMS: Early rehabilitation exercise has been shown to reduce the onset of disability in patients following acute stroke. However, the clinical execution rate of early rehabilitation exercise for those patients remains low. Our medical team developed an early rehabilitation care plan for patients with acute stroke in 2013, at which time the execution rate of early rehabilitation exercise for these patients in our hospital was only 37.1%. The survey found that patients and caregivers had insufficient awareness of early rehabilitation exercise; hospital staffs lacked appropriate assistive devices, rehabilitation equipment, nursing guidance tools, and handover records; and new nursing staffs were insufficiently aware of the importance of early rehabilitation exercise. This care plan was developed to improve the execution rate of early rehabilitation exercise in patients with acute stroke to slow the progression of their disability.
The project was designed to improve the knowledge of new nursing staffs regarding early rehabilitation care and the early rehabilitation exercise completion rate of nursing staffs to raise the execution rate of early rehabilitation exercise in patients with acute stroke.
After completing the cause analysis, multiple strategies were pursued: (1) nursing education sheets with texts, illustrations, video, and posters were used; (2) group in-service educational training was organized; (3) an innovative transfer belt was designed; (4) facilities were set up to deliver virtual-reality (VR) training; (5) standard procedures on early rehabilitation exercise in patients with acute stroke were revised and implemented; (6) nursing handover procedures were revised; and (7) education courses on early rehabilitation exercise for post-stroke patients were developed.
The accuracy of knowledge related to early rehabilitation exercise among new nursing staff improved from 31.3% to 80%; the completion rate for nursing education increased from 53.6% to 98%; and the early rehabilitation exercise execution rate increased from 37.1% to 82.8%.
This project successfully increased the motivation and confidence of patients in rehabilitation and the rate of exercise program execution, which may be expected to impact positively on patients' quality of life.
早期康复锻炼已被证明可降低急性中风患者残疾的发生率。然而，这些患者早期康复锻炼的临床执行率仍然很低。我们的医疗团队在2013年为急性中风患者制定了早期康复护理计划，当时我院这些患者早期康复锻炼的执行率仅为37.1%。调查发现，患者和护理人员对早期康复锻炼的认识不足；医院工作人员缺乏合适的辅助设备、康复器材、护理指导工具和交接记录；新入职护理人员对早期康复锻炼的重要性认识不足。制定此护理计划旨在提高急性中风患者早期康复锻炼的执行率，以减缓其残疾的进展。
该项目旨在提高新入职护理人员对早期康复护理的认识以及护理人员早期康复锻炼的完成率，以提高急性中风患者早期康复锻炼的执行率。
在完成原因分析后，采取了多种策略：（1）使用包含文字、插图、视频和海报的护理教育资料；（2）组织小组在职教育培训；（3）设计了一种创新的转移带；（4）设立了提供虚拟现实（VR）训练的设施；（5）修订并实施急性中风患者早期康复锻炼的标准程序；（6）修订护理交接程序；（7）开发了中风后患者早期康复锻炼的教育课程。
新入职护理人员中与早期康复锻炼相关知识的准确率从31.3%提高到了80%；护理教育的完成率从53.6%提高到了98%；早期康复锻炼的执行率从37.1%提高到了82.8%。
该项目成功提高了患者康复的积极性和信心以及锻炼计划的执行率，有望对患者的生活质量产生积极影响。
