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摘要


組合式照護是透過跨專業的合作模式輔以實證性照護方案來優化、標準化團隊照護過程,以此提升病人照護成果;在臨床上應用此模式而陸續發展不同的照護組合,例如呼吸器病人照護、施行中心靜脈導管術與休克處置。建置組合式照護模式時可依循六大指引,包括建立照護團隊成員所認同的措施、措施間具備互相獨立的特性、符合專業特性與病人族群、由跨團隊共同建置、考量地域性因素與臨床判斷。本文介紹某醫學中心參與衛福部疾管署推動中心導管照護品質提升計畫之組合式照護的導入過程和血流感染率改善的成效。

並列摘要


This article describes the improvement of catheter related bloodstream infection rate of a medical center after implementation of a central catheter care bundle. “Care bundle” is a structured model of care that applies evidence-based standard of care across an interdisciplinary collaborative team to optimize quality of patient care. Established care bundles include care of patients under mechanical ventilation, central catheter insertion and shock management. Structure of a care bundle model consists of six guidelines: (1) building the interventions on which care team members agree, (2) independence among interventions, (3) consideration for practice area and patient population, (4) grouping an interdisciplinary team, (5) involving geographic factors and (6) clinical judgments.

參考文獻


Marang-van de. Mheen, P. J. & van Bodegom-Vos, L. (2015). Meta-analysis of the central line bundle for preventing catheter-related infections: A case study in appraising the evidence in quality improvement. BMJ Quality & Safety, 1-12. doi: 10.1136/bmjqs-2014-003169
宋雅雯、黃敏鎔、周晉伊、洪靖慈、蔡忠榮、陳淑惠(2014).運用跨領域團隊組合式照護改善內科加護病房中心導管相關血流感染率.護理雜誌,61(3),87-95。
林佩儀、景秀蘭、簡政怡、黃惠美(2014).提升加護病房醫護人員執行中心導管組合式介入措施之完整率.榮總護理,31(3),286-294。
姚淑琴、陳孟君、鍾英菊、梁蕙芳(2014).運用組合式照護降低加護病房中心靜脈導管血流感染率.長庚護理,25(4),413-423。
黃建賢、林鎮均、李淑華、謝怡然、何冠儀、鍾佳芸(2012).導入組合式管染管制措施以降低中心導管相關血流感染.臺灣醫學,16(4),410-415。

被引用紀錄


黃燕秋、張雅竹、吳莒瑛、徐紫娟、林淑芬(2020)。運用睡眠組合式照護提升加護病房病人睡眠品質護理雜誌67(4),98-105。https://doi.org/10.6224/JN.202008_67(4).12
蔡佳容、黃詠婷、潘慧娟、陳繪竹(2019)。降低急性病房留置導尿管相關泌尿道感染密度之專案台灣專科護理師學刊6(1),22-33。https://www.airitilibrary.com/Article/Detail?DocID=P20150413001-201903-201904090016-201904090016-22-33

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