- 期刊
運用醫療品管圈推行安寧共同照護服務
Promote Hospice Shared-Care Using Quality Control Circle
摘要
為妥善利用醫療資源，協助非安寧病房癌症末期病人在安寧緩和醫療的照顧下安然走完人生，國民健康局透過「安寧共同照護計畫」補助各醫院成立「安寧共同照護團隊」，與原診療團隊共同硏擬符合病人需求的安寧共同照護計畫，將安寧療護擴展至非安寧病房的的癌症末期患者照顧。本硏究透過醫療品管圈手法，以「課題達成活動」的運作方式，推行安寧共同照護服務。由安寧共同照護團隊與經常收住癌症病患的病房護理長共同組成醫療品管圈，透過圈員腦力激盪，研擬具創意性的最適策，包括：建構安寧共同照護服務標準作業模式與個案管理資訊系統、培訓專職安寧共照護理師與原診療單位的安寧共照連結員共同參與照護服務、辦理推行安寧共同照護服務的宣導講座、設計專屬標章貼紙、建構網頁等宣導策略，使得預定的收案目標能如期達成，且服務對象與原診療團隊人員皆對安寧共同照護服務感到滿意。運用醫療品管圈手法能讓非安寧病房的護理人員得以透過各項活動與安寧共同照護團隊有實質且密切的交流機會，溝通各種照護歧見，並提昇臨床安寧照護技能；藉由「由下而上」的決策機會所建構而成的全院性安寧共同照護標準作業流程，也可以符合醫院的文化特性。所以，「醫療品管圈」活動是各醫院在推行安寧共同照護或推動新的服務模式時均可以參考運用的方式。
並列摘要
To improve the quality of end-of-life care, the Bureau of Health Promotion proposed a nationwide project to support palliative care for terminal cancer patients in non-hospice ward by hospice shared-care model in 2003. The hospice shared-care model was a new subject for most hospitals in Taiwan. We initiated a quality control circle (QCC) composed of members of palliative care team, nursing staff of non-hospice ward and a social worker to facilitate the implementation of this new patient care model in our hospital. The brainstorming of QCC members created several strategies to accomplish this goal. These strategies included setting up online consulting and case management system for hospice shared-care, formulating standard operating procedure for delivering palliative shared-care in non-hospice ward, training fulltime nurse for hospice shared-care and coordinate-nurse of non-hospice ward, offering professional palliative education program, posting reminding sticker on the cover of chart and phone of ward, and building website to introduce hospice shared-care model. The involvement of non-hospice ward nursing staff in the QCC activity has made an optimal hospice shared-care model fit for the hospital culture.
延伸閱讀
- 何致德、林文元、林正介（2011）。安寧共同照護服務：社區推展的創新模式。台灣醫學，15(1)，32-36。https://doi.org/10.6320/FJM.2011.15(1).06
- 林展弘（2017）。共同建構安全院所 提供病患安心醫療。首都中醫報導，(35)，1-1。https://www.airitilibrary.com/Article/Detail?DocID=P20121015003-201706-201706060014-201706060014-1-1
- 周佩君、林雅卿、鄭如芬、溫如玉（2012）。應用團隊資源管理於安寧照護團隊。安寧療護雜誌，17(2)，133-145。https://doi.org/10.6537/TJHPC.2012.17(2).1
- 賴昭智、鄭展志、洪子堯、李彬州、林耿孝、璩大成、黃勝堅、林宏嶽、黃永忠、急診安寧研究小組（2016）。急診安寧緩和醫療整合照護模式之建立。北市醫學雜誌，13(3)，36-47。https://doi.org/10.6200/TCMJ.2016.13.3.05
- 陳冠綸、黃獻樑（2021）。Hospice Palliative Care for Patients with Heart Failure。台灣家庭醫學雜誌，31(2)，87-95。https://doi.org/10.3966/168232812021063102002