加護護理人員對意識鎮靜之知識程度與所提供之護理活動
相關因素之探討.
Knowledge of Conscious Sedation and the
Performance of Corresponding Nursing Interventions
of ICU Nurses
邱艷芬 Shei PI;Chao YF 摘要 意識鎮靜在目前國內各大醫院心加護中心，是一種逐漸被推廣使用的輔助醫療方 式。本研究旨在探討加護護理人員對意識鎮靜的知識程度與其所提供之護理活 動、知識程度想護理活動間相關性及其相關因素，以橫斷式結構式自擬式問卷進 行調查，於 89 年 11 月至 90 年 2 月止，採立意取樣之方式，於南部地區各醫學 中心、區域醫院及地區醫院共十一家醫院之加護中心，具有護理師或護士執照之 臨床護理人員搞研究對象，共發出 650 份問卷，回收有效問卷 513 份。問卷內容 共分四大部分，包含基本資料、意識鎮靜知識部分、意識鎮靜藥物知識部分、及 護理活動。所得資料以描述性統計、卡方檢定及皮爾森相關性分析進行資料分 析，研究結果歸納如下： 大部分護理人員對意識鎮靜知識（用藥應具特色、優 點、對醫護人員的好處、目的、副作用、深度意識鎮靜、合併症）及意識鎮靜藥 物（ Propofol、Midazolamn、Atracurium 等）的知識，皆具有中等以上的認識（得 分百分比分別為 77.8%與 79.9% ）。其中對意識鎮靜的優點、意識鎮靜目的、意 識鎮靜藥物 Propofol 及 Midazolam 等部分，皆有 80%以上的瞭解情形。但其中 意識鎮靜對醫護人員的好處、意識鎮靜副作用及對意識鎮靜藥物 Atracurium 的 認識，瞭解程度較差（皆< 75%）。護理人員之年齡、教育程度、加護工作單位、 工作總年資及醫院層級等，皆與護理人員對意識鎮靜知識的瞭解程度有相關。護 理人員對意識鎮靜病患應執行之護理活動皆有九成以上之執行情行，其主要受加; 建工作單位、醫院層級等影響。而知識得分愈高，護理人員正確執行護理活動之 比例也就愈高。知識來源中研習會、在職教育及自行閱讀文獻與意識鎮靜知識及 意識鎮靜藥物知識有相關，且以自行閱讀文獻及在職教育影響最多。 依據研究 結果，本研究建議提昇護理人員之教育水準、加強加護單位意識鎮靜知識的在職 教育，鼓勵及提供相關文獻等，以充實加護護理人員的意識鎮靜觀念及知識，提 手對病患應有護理照顧之執行率：本研究之結果也可供相關教育研究單位之參
考。
Abstract
Conscious sedation is gradually gaining acceptance as a supplementary treatment in the ICUs of many Taiwanese hospitals. This study investigates the relationship
between knowledge of conscious sedation and the interventions of nurses in the ICUs. A cross-section research design was adopted and subjects were recruited from medical centers, and regional and local hospitals in southern Taiwan. The study period lasted from November 2000 to February 200 I, and a total of 513 nurses were enrolled. The questionnaire comprised the following: knowledge of conscious sedation, knowledge of sedative drugs, and nursing interventions. The major statistical procedures applied in data management were: descriptive statistics. Chi-square, t test, One-way ANOVA and Pearson's Correlation. The survey results were as follows: The Score of the nurses in their knowledge of conscious sedation was 77.8 on a scale If 100, while for
knowledge of sedative drugs the average score was 79.9. The significant influences on nurses' knowledge of conscious sedation were: age, education level, years working in ICUs, years working as a nurse, and the type of hospital they worked in. The rate of providing appropriate nursing care to patients on conscious sedation exceeded 90%, and of the performance of appropriate nursing interventions increased with the provision of appropriate nursing care to patients. The knowledge sources used by nurses included symposiums, hospital education and private study. Results in this study suggest that, to increase nurses' knowledge of conscious sedation and their performance of nursing interventions based on this concept, the education level of nurses in ICUs should be promoted and hospital education enhanced. The information provided by this study can serve as a good reference in planning on the job education for ICU nurses whose units use conscious sedation.
