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抽痰及照護能力模組課程與教學設計之研究

論文名稱(中/英文) 研究生 指導教授

抽痰及照護能力模組課程與教學設計之研究
An Exploration of the Effectiveness of the Suctioning skills and Nursing Modular Courses for New Nurses

in Medical-Surgical Wards

潘夙娟 徐曼瑩博士
[  摘要  ]
臨床需要仰賴抽痰來維持生命的病人,多為意識不清、有肺部疾患及無法自行咳痰者,抽痰與照護任務的執行是在醫師開立
抽痰處方後,由護理人員察覺病人需抽痰的情境線索、異常徵象與症狀,綜合判斷與作決策後,提供合宜抽痰與照護措施。
所以,抽痰與照護任務是臨床護理人員不可缺少的執業能力之一。若要讓護理新人在執業初期即掌握各類的抽痰情境,精熟
抽痰與照護流程及其步驟。則需要有情境執業能力取向的課程與教材。有鑑於此,本研究目的在(一)建構與標準化內外科
病房抽痰與照護任務流程,(二)設計抽痰與照護能力訓練模組課程及教材。
本研究以內外科病房為研究情境,經過三階段進行。第一階段:模組化課程,包含六步驟,分別為:(一)分析抽痰與照護
任務執行能力的訓練需求、(二)建構與標準化抽痰與照護的執行流程、(三)確認抽痰與照護的執行能力、(四)分解流
程執行能力為小單元能力、(五)歸納小單元能力並撰寫學習目標、和(六)依據學習目標訂定評值指標、規準及其評值方
式與工具。第二階段:模組化教學,包含二個步驟,分別為(一)編輯模組課程與教材、(二)以樹狀結構呈現模組課程與
製作的多媒體教材說。第三階段:檢核修正模組品質,包含三個研究步驟,分別為:(一)檢核模組教材與品質、(二)修
正模組教材與品質、(三)設計學習手冊。
研究結果包括:(一)標準化抽痰與照護流程圖;(二)內外科病房執行抽痰與照護流程必須具備的執行能力;(三)抽痰
與照護能力模組化課程;(四)抽痰與照護模組化教材、評值方式與工具;(五)抽痰與照護模組課程的學習手冊。本模組
課程與教材設計配合學習手冊學習,提供給護校生臨床選習或護理新人到職前的自我導向學習之用。
本研究模組課程研究的範圍以署立醫院的內外科病房的學習情境,研究者初次執行焦點團體訪談,在考量研究目標與主題
後, 針對「抽痰與照護能力模組課程」課程目標及五個模組探索問題,獲取參與者對課程內容連貫性的看法,所以,請六
位參與者參與六個主題的焦點團體訪談,結論能作為其他課程研究之參考。
[ Abstract ]

Patients who rely on suction to remain alive in clinical settings are mostly unconscious, suffering from lung diseases, 
and unable to cough up sustain themselves. Suction nursing care tasks provides appropriate suction nursing measures 
with decisions regarding what measures are appropriate being made by a doctor based on the suction scenario and 
any abnormal signs and symptoms. Therefore, suction nursing care is a required practical ability for clinical nurses. 
Practice oriented courses and course materials are needed help new nurses control various unfamiliar suction scenarios 
and become proficient in suction nursing care process and its steps. Consequently, suction nursing care is a key 
competency that clinical nursing staff should practice. To ensure patient safety, it is necessary to let new nursing 
staff handle various suction situations, familiarize themselves with suction, and implement procedures and steps involved 
in nursing care. Accordingly, this study has the following objectives: (1) to devise standardized procedures and 
instructions for suction nursing care in internal medicine and surgical wards, (2) to design modular curriculum and 
materials for suction nursing care.
This study investigates medicine and surgical wards via a three stage approach. Stage 1 : design module courses via the 
following six steps: (1) analyze the requirements for training nurses in practical suction care, (2) develop instructions and 
standardized execution procedures for suction nursing care, (3) develop a means of confirming the ability of individuals 
to administer suction nursing care, (4) decompose the various abilities required to administer suction nursing care into 
small units, (5) summarize these small units detailing suction nursing care abilities and draft learning objectives, and (6) 
establish evaluation indicators, benchmarks and evaluation methods and tools related to learning objectives. Stage 2: 
develop modulated teaching practices via the following two steps: (1) edit modular curriculum and course materials,
(2) demonstrate modular curriculum under a tree structure and describe multimedia course materials. Stage 3: check 
and revise module quality via the following three steps: (1) check modular curriculum materials and quality, (2) revise 
modular curriculum materials and quality, (3) design a learning manual. 
This study obtained the following outcomes: (1) a standard flow chart regarding suction nursing care, (2) a list of 
indispensable competencies for executing suction nursing care in internal medicine and surgical wards, (3) a set of 
modularized materials, evaluation techniques and tools for suction nursing care and (5) a set of practical guidelines for 
developing modularized curriculum of suction nursing care. To associate the modularized curriculum and materials with
the set of practical guidelines, this study provides clinical practice for nursing school students and instruction on 
self-learning for pre-service nursing staff.
T his study is the first to use focus groups to examine modular curriculum in the context of internal medicine and hospital 
surgical wards of national hospitals. After considering the study objectives and topic, this investigation focused 
on “modular curriculum for suction nursing care” and five questions regarding modular probation, and obtained 
participant views regarding curriculum consistency. This investigation thus invited six participants to attend six focus 
group visits dealing with six topics. The results of the focus group visits provide a reference for other investigations 
dealing with different curriculums