気管吸引の技術演習による学生の学び安全かつ患者の苦痛に配慮した的確な気管吸引技術の習得に向けて

本研究の目的は，安全かつ患者の苦痛に配慮した的確な気管吸引技術の習得に向けた看護教育を検討するために，気管吸引の講義および演習での技術習得に加え，「吸引を受ける患者の身体的・心理的状態について推し測ったこと」「看護師として吸引を行う上で配慮すべき大切なこと」という２つのレポート課題を通し，看護学生が，「看護師として吸引を行う上で配慮すべき大切なこと」と考えた内容を明らかにすることである．
対象はA看護系大学の３年生で，気管吸引の技術演習後に「看護師として吸引を行う上で配慮すべき大切なこと」について自由記述されたレポートをテキスト分析した．
看護学生が「看護師として吸引を行う上で配慮すべき大切なこと」と考えた内容は６つのドメインに統合され，最も回答数が多かったのは【吸引を受ける患者の理解】であった．
【吸引を受ける患者の理解】は【吸引を受ける患者に寄り添った声掛け】および【吸引に伴う合併症を理解した負担の少ない手技】と強く共起していた．学生は，「看護師として吸引を行う上で配慮すべき大切なこと」として【吸引を受ける患者の理解】に導かれる身体面への配慮と心理面への配慮を表現していた．
吸引の安全性をさらに高めるためには回答数が少ない【吸引の全過程における患者の状態観察とアセスメント】【効果のある確実な吸引技術】を強化する必要があり，講義・演習・レポートに加え，学生個々の記述を，グループで共有し看護としての妥当性・過不足の面から吟味し検討する教育の必要性が示唆された．

This research study examined the effect of teaching-learning on the proper intratracheal aspiration technique with the maximum attention on preventing pain during the procedure. To conduct the study, the participants were third year nursing students at A nursing university. They were required to take lectures on intratracheal aspiration and subsequently demonstrate mastery of the technique from practicing. They were also required to write their experiences based on two themes : How to assess the physical and psychological status of patients undergoing aspiration? and, What should be considered as important for a nurse to carry out intratracheal aspiration? After the practice sessions, students submitted their free-writing style reports for text analyses conducted by the researchers. “Correct understanding on the side of the patient” was the most common answer to the question of “what should be considered to be important for a nurse to carry out intratracheal aspiration?” This answer concurs strongly with two other answers : “saying something by the side of the patient undergoing aspiration” and “a technique imposing little burden on the patient faced with aspiration.”From these data, the students expressed the need to care for the physical and psychological aspects of patients. To strengthen the safety of of patients from aspiration, it was necessary to improve “the observation and assessment of the status of patients throughout the process of aspiration,” and develop “a more effective and secure intratracheal aspiration technique.” Both of these items ranked low in the list of answers. It was indicated that remarks from individual students in addition to lectures, practice, and reports needed to be shared and be incorporated into an educational content and method that aimed at examining patient safety from aspiration during intratrachel technique considering aspects of relevancy and appropriateness of nursing practice policies.