利用資訊系統優化急診部ACLS流程

Using an Information System to Optimize the ACLS Process at the Emergency Department

賴佩芳(Pei-Fang LAI) ； 吳彬安(Ping-An WU)

《護理雜誌》 65卷4期 (2018/08) Pp. 24-29

https://doi.org/10.6224/JN.201808_65(4).05

摘要

美國心臟協會（American Heart Association, AHA）在2015發表更新的高級心肺復甦術（advanced cardiac life support, ACLS）照護準則，強調團隊急救概念，不但要有標準動作，成員更要熟悉在急救中不同的角色並互相合作。然而實際運用ACLS時，容易因為緊張及不熟悉流程而事倍功半，不過ACLS並不是一套複雜的內容，不會因為不同原因的心跳停止而必須採取不同急救流程，因此本文運用資訊系統輔助醫護團隊完全正確執行ACLS流程，將固定頻率的動作交給資訊系統去運作，醫護團隊可以更專心及精準的執行急救動作，不會受到記憶誤差之影響，醫護團隊可以在資訊科技協助下完成急救。資訊系統根據ACLS流程執行計時、提示及指導，並將急救中需要運用之程序（壓胸、建立靜脈途徑、置入氣管內管、電擊、藥物種類及劑量），以點擊方式記錄，檔案上傳後同時完成醫護病歷作業。醫護同仁正確使用此資訊系統，不但能協助高級心肺復甦術之執行，減輕醫護同仁臨床和書寫病歷之負擔，更能確實提升急救照護品質。

關鍵字

心臟停止 ； 高級心肺復甦術 ； 資訊系統 ； 急救品質

並列摘要

The best first-aid treatment for cardiac arrest patients is advanced cardiac life support (ACLS) in terms both of saving lives and of reducing the incidence of sequelae. The American Heart Association (AHA) published updated ACLS guidelines for care in 2015. These updated guidelines emphasized the importance of teamwork in resuscitation, noting that, in addition to standard procedures, team members should be familiar with their distinct roles and should cooperate together during emergent situations. Implementing ACLS is not easy due to stress and unfamiliarity with the process and thus often achieves less-than-optimal results in practice. However, ACLS is a standard approach that uses the same procedures to address different cardiac arrest situations. Therefore, we wanted to use an information system to assist the medical team to fully implement the ACLS process. The information system helps the medical team perform resuscitation actions more intensively and precisely while avoiding problems and mistakes due to forgetfulness / unfamiliarity, facilitating an optimal resuscitation effort. Concurrently, electronic medical and nursing records are completed automatically, avoiding the need for medical staff to compile these records afterwards. This information system helps save time and effort and improves precision. Furthermore, data analysis is more convenient, which facilitates the effective management and supervision of resuscitation quality. The information system performs timing, prompting, and guidance in accordance with the ACLS process and records the procedures that will used in emergency treatment (i.e., chest compression frequency, establishment of intravenous route, placement of endotracheal tubes, electric shock, drug type, dose) with a simple click of a mouse. Finally, the associated medical record is completed and logged as soon as the automatically generated file is uploaded. All hospital staffs may use this information system to assist in the implementation of advanced CPR. The system improves the quality of the first aid measures applied in life support, reduces the burden on clinics and medical staff, and streamlines the preparation and submission of medical records.

並列關鍵字

cardiac arrest ； advanced cardiac life support (ACLS) ； information system ； resuscitation quality

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