臨牀透析 Vol.19 No.3(3-2-1)


特集名 透析医療における看護の質と量 -- 看護度設定とその効果
題名 透析室における看護度設定の試み (1) 大阪府立病院における活用状況の実際と意義
発刊年月 2003年 03月
著者 春木谷 マキ子 大阪府立病院・看護師
著者 岩井 典子 大阪府立病院・看護師
著者 城 美鈴 大阪府立病院・看護師
著者 池田 尚未 大阪府立病院・看護師
【 要旨 】 重篤な合併症を有する透析患者が増加し,透析中さまざまなイベントを呈することから看護に苦慮する.当院独自に作成した血液透析看護度表は患者の重症度を的確に把握でき,事故防止などにも有効である.今回,透析看護経験の相違による利用法やメリットを検証するため,看護経験3カ月の新人,経験3年,5年の各看護師に対し看護度表の活用法や実地の看護展開について記述式アンケートにて検討した.新人はマニュアルの一つとして活用し,経験3年の看護師は,ケア項目と根拠から速やかに目標,ケアプランを立て,中等度の看護度の患者を問題意識をもって看護している.経験5年の看護師は,速やかな判断と迅速な対処が必要とされるもっとも重症の患者を受け持っているが,看護度により重症の捉え方や分類を自分なりに行え,難なく看護に当たっている.また,経験5年の看護師には主任不在時の代行という責務もあり,新人指導や管理面にも活用している.看護度表は透析中の看護ケアの変化が経時的に理解でき,担当が変わっても共有可能で,新人教育の材料となり,継続したケアによりレベルの維持,質の向上にも活用できる.
Theme The Quality of Nursing for Dialysis Treatment and the Amount of Nursing Available
Title Practical significance of the degree table for hemodialysis nursing -- Osaka Prefectural General Hospital
Author Makiko Harukidani Department of Nursing, Osaka Prefectural General Hospital
Author Noriko Iwai Department of Nursing, Osaka Prefectural General Hospital
Author Misuzu Jho Department of Nursing, Osaka Prefectural General Hospital
Author Naomi Ikeda Department of Nursing, Osaka Prefectural General Hospital
[ Summary ] During dialysis, nursing is made difficult because of various accidents. This is due in part to the increase in the number of patients who have severe complications. Our original degree table for hemodialysis nursing can be precisely understood in relation to degree of patient illness and is effective for accident prevention. At this time, we are inspecting the usage and merit of the table in different types of dialysis nursing. We examined the practical use of and developments in nursing care in relation to degree table for hemodialysis nursing. Nurses with over three years experience were questioned over a three to five year period, concerning hemodialysis nursing. This information resulted in a new manual. Nurses with 3 years of experience had the goal of creating a care plan to immediately treat patients for whom of medium level nursing care is necessary. Nurses with five years experience took charge of the most seriously ill patients, prompting assessments where quick care is needed. By using the nursing the degree table for hemodialysis, they were able to evaluate degree of illness and a classification by themselves. In addition, this method helps to develop new types of education and management.
We can understand the necessary changes in nursing care time and degree by using the table for hemodialysis nursing and share information. This is possible even if the person in charge is switched, and care can be maintained. The degree table for hemodialysis nursing is useful for creating materials for new forms of education or to improve quality of nursing.
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