本文是探討一位血液透析病人經歷動靜脈管反覆阻塞的護理經驗，筆者於2010年3月27日至5月31日照護期間，藉由直接照護、會談、電訪及身體評估等方式，運用Gordon十一項健康功能型態評估進行資料收集，確立個案呈現體液容積過量、健康維護能力改變、無望感等健康問題。護理過程中，筆者與個案、案妻共同擬訂飲食（水分）控制及動靜脈管的照護計畫，協助設計「每日水分攝取量與體重記錄表」及「管自我照護檢測本」，以增進個案自我健康照護能力；並安排個案及案妻參加腎友會、團體衛教等活動，提供支持系統和提升自我價值感，協助個案以正向的態度面對透析治療、降低無望感。期望藉由此個案的護理經驗分享，提供護理同仁照護相關個案之參考。

The complex environment of the hemodialysis unit provides multiple opportunities for health care workers to sustain sharps injuries. Research showed that nurses sustained the highest number of sharps injuries among all health workers. The sharps injury rate in the hemodialysis unit was 16.6% (5/30) in 2010, higher than other units of nursing department at Hsinchu Branch of the National Taiwan University Hospital. An ad hoc group was therefore established with the goal of reducing the rate of sharps injuries and preventing blood-borne diseases related to sharps injury such as Hepatitis B, Hepatitis C and Syphilis. Using the observation checklist and cause-and-effect diagram, the main causes of sharps injuries were determined to be due to the high number of environmental risk factors, lack of awareness on sharps injury prevention, and impractical standard operating procedures for needle puncture and removal. Preventive strategies made by decision matrix analysis included elimination of environmental hazards, improving awareness on sharps injury prevention among nurses, and revising standard operating procedures for arteriovenous shunt puncture and needle removal. After these strategies were implemented, sharps injury rate was decreased to 0.00%. The policies recommended for reducing occupational injuries are illustrations and mnemonics for improving memory of standard techniques, encouraging health care workers to participate in the creation of a safe work environment, and improved awareness.