- 期刊
提升麻醉術後病人轉出恢復室體溫之回溫率
Project for Enhancing Rewarming for Patients after General Anesthesia in recovery room
摘要
背景：病人於麻醉手術過程中，因麻醉藥物抑制體溫調節中樞及手術室低溫環境等因素導致體溫下降，影響麻醉藥物代謝而延遲意識甦醒、寒顫增加耗氧等情形，故積極主動回溫極為重要。檢視2020年本單位麻醉術後病人於恢復室回溫率僅75.6%，原因分析為護理師對麻醉後恢復照護規範不清楚、未制定低體溫處置流程、缺乏在職教育及稽核制度、保暖照護設備不足等因素。目的：提升麻醉術後病人於轉出恢復室體溫≧36℃之回溫率由75.6%上升至90%以上。解決方案：制定麻醉術後低體溫處置流程、舉辦低體溫跨領域課程、增設體溫保暖與評估設備，以及導入資訊化照護策略等措施。結果：麻醉術後病人轉出恢復室體溫≧36℃之回溫率由75.6%提升至100%；護理師對低體溫照護之認知正確率由65.0%提升至100%。結論：建議針對麻醉手術低體溫高危險群，運用資訊化系統性整合，術前及早預防、術中適切保暖與術後積極回溫的黃金三角，以提供麻醉手術病人優質的照護品質。
並列摘要
Background: During surgery, the administration of anesthetic drugs can suppress the thermotaxis center, which, coupled with the typical low-temperature environment of the operating room, can lead to a drop in the patient's body temperature. This drop has various adverse effects, including delayed awakening from anesthesia due to the metabolism change of the anesthetic drugs, and increased oxygen consumption due to shivering. Actively restoring body temperature is crucial in such cases. In 2020, the temperature recovery rate of patients in our recovery room after anesthesia was 75.6%. The contributing factors of low recovery rate included a lack of clarity among nurses regarding postanesthesia recovery standards, the absence of hypothermia treatment procedures, inadequate on-the-job education and auditing systems, and insufficient thermal care equipment. Purpose: To increase the temperature recovery rate from 75.6% to 90% of patients with a body temperature over 36°C before transferring from the recovery room after anesthesia to the wards. Solution: Several measures were implemented, including the development of postanesthesia hypothermia treatment protocols, the provision of interdisciplinary hypothermia courses, the incorporation of temperature preservation and assessment equipment, and the introduction of information-based care strategies. Results: After the implementation of these measures, the recovery rate of patients before transferring from the recovery room reaches 100%. Moreover, nurses' scores regarding their perception of hypothermia care increased from 65.0% to 100%. Conclusions: The systematic integration of information technology, particularly for high-risk groups of low body temperature, and the golden triangle approach of early prevention before surgery, appropriate warming during surgery, and proactive rewarming after surgery should be provided to ensure high-quality care for patients after anesthesia in recovery room.