提升加護病房護理師對FloTrac之認知及技能正確率

背景：FloTrac可監測病人的血液動力學，缺乏儀器認知及操作不熟練，可能危害病人安全，故引發專案改善動機。目的：護理師對FloTrac認知正確率由57.6%提升至85%；護理師對FloTrac技能正確率由73.3%提升至91%；護理師以碼表計時裝置FloTrac平均完成時間低於8分38秒。解決方案：構思創意口訣、製作操作技能教學影片、簡易操作手冊、提醒小卡、舉辦在職教育及定期品質監控。結果：護理師對FloTrac認知正確率由57.6%提升至90.4%，技能正確率由73.3%提升至99.7%，裝置完成時間由8分38秒縮短至5分42秒。結論：經由實施改善策略後讓護理師提升專科的知能，並有效率的輔助醫師取得血液動力學數據，提供重症病人精確且快速的治療處置。

關鍵字

血液動力學；弗羅威克；重症護理師；加護病房；認知及技能

並列摘要

Background & Problems: FloTrac is used to monitor hemodynamics in patients. Insufficient awareness of and inexperience with this machine put patients at risk. Purpose: A project was developed to increase FloTrac cognitive accuracy from 57.6% to 85% and skill accuracy from 73.3% to 91% in ICU nurses. Also, FloTrac installation time was intended to be reduced to less than 8 minutes and 38 seconds. Resolution: Create a pithy, easy-to-remember formula; make operation teaching videos, operation manuals, and reminder cards; arrange educational training; and monitor quality regularly. Results: FloTrac cognitive accuracy increased from 57.6% to 90.4%; FloTrac skill accuracy increased from 73.3% to 99.7%; and installation time was shortened from 8 minutes and 38 seconds to 5 minutes and 42 seconds. Conclusions: After implementation of the project, nurses improved their professional knowledge and were better able to help doctors obtain hemodynamic data efficiently to provide patients with accurate and rapid treatment.

並列關鍵字

hemodynamics ； FloTrac ； intensive care nurse ； intensive care unit ； cognition and skill

參考文獻

張明真、鈕淑芬、張元玫（2019）．醫院臨床護理教學策略模式．領導護理，20（3），22–31。[Chang, M.-C., Niu, S.-F., & Chang, Y. (2019). The clinical nursing teaching strategies for hospital. Leadership Nursing, 20(3), 22–31.] https://doi.org/10.29494/LN.201909_20(3).0003

張玠、陳筱瑀（2017）．數位學習在護理教學之應用．數位與開放學習期刊，（7），1–25。[Chang, J., & Chen, H.-Y. (2017). The implementation of e-learning to nursing teaching. The Journal of Open and E-Learning, (7), 1–25.] https://doi.org/10.6748/JOEL.201710_(7).01

簡維宏（2019）．ERAS術中體液平衡輸液管理策略．台灣醫學，23（2），206–211。[Jean, W.-H. (2019). ERAS guideline for fluid management. Formosan Journal of Medicine, 23(2), 206–211.] https://doi.org/10.6320/FJM.201903_23(2).0008

Björn, A., Pudas-Tähkä, S.-M., Salanterä, S., & Axelin, A. (2017). Video education for critical care nurses to assess pain with a behavioural pain assessment tool: A descriptive comparative study. Intensive and Critical Care Nursing, 42, 68–74. https://doi.org/10.1016/j.iccn.2017.02.010

Pour-Ghaz, I., Manolukas, T., Foray, N., Raja, J., Rawal, A., Ibebuogu, U. N., & Khouzam, R. N. (2019). Accuracy of non-invasive and minimally invasive hemodynamic monitoring: Where do we stand? Annals of Translational Medicine, 7(17), Article 421. https://doi.org/10.21037/atm.2019.07.06

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