身心科急性病房護理團隊於急救小組到達前之急救流程改善方案

Improving Emergency Nursing Care Workflow of First Aid Response Before Emergency Team Arrival in Acute Psychiatric Ward Setting

彭淑敏(Shu-Min Peng) ； 林欣薇(Hsin-Wei Lin) ； 辜美安(Malcolm Koo) ； 詹怡佳(Yi-Chia Chan)

《榮總護理》 36卷2期 (2019/06) Pp. 152-161

https://doi.org/10.6142/VGHN.201906_36(2).0005

摘要

本專案旨在改善身心科急性病房護理團隊於急救小組到達前之急救流程。護理團隊急救實務經驗少，加上院方在本病房進行無預警急救測試，結果發現病房成員對急救標準流程不清楚、缺乏團隊分工及急救技術不完整，故成立專案小組期望能改善急救小組到達前，病房護理成員急救相關技術完整率達≥ 95%。經介入增修訂各項急救表單，建立急救流程標準及團隊分工架構，規劃教育訓練等措施後，四項急救相關的護理技術完整率分別為：心肺復甦術由25%提升至97%，電擊器操作由50%提升至100%，氣管插管備物由39%提升至95%，抽痰術由13%提升至100%。此外，團隊分工完整率達96%，搬運病人花費時間由1分48秒縮短至1分12秒。本專案透過規劃分工與系統性教育訓練後，有效提升急救流程完整率，增進病人安全。

關鍵字

急救流程 ； 心肺復甦術 ； 團隊分工

並列摘要

This project aimed to improve the nursing care workflow of the first-aid response before the arrival of the emergency team in an acute psychiatric ward setting. We performed an unannounced first-aid drill and found that the nursing staff in an acute psychiatric ward was unclear regarding the standard operating procedure for first aid, had no clear plan for the division of labor, and had incomplete knowledge regarding first-aid techniques. Therefore, an improvement project team was established to improve the division of labor among nursing staff and perform first aid-related techniques with a completion rate of ≥ 95% before the arrival of the emergency team. The improvement team added and revised the first-aid forms, established a standard operating procedure for first aid, devised a scheme for the division of labor, and planned training courses. After project completion, the completion rates of nursing techniques, namely cardiopulmonary resuscitation, defibrillator use, tracheal intubation, and sputum clearance, increased from 25% to 97%, 50% to 100%, 39% to 95%, and 13% to 100%, respectively. The completion rate for the division of labor reached 96%, and the time required to transport patients decreased from 1 min 48 s to 1 min 12 s. Thus, the completion rates for first-aid techniques improved after the training, indicating the effectiveness of the improvement project.

並列關鍵字

first aid ； cardio pulmonary resuscitation ； division of labor

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