降低新生兒加護病房護理人員輸入資訊化病人分類不正確率

Patient Classification Information Technology System Entered Incorrectly by Nurses in a Neonatal Intensive Care Unit

王筱華(Sheau-Hwa Wang) ； 張美玉(Mei-Yu Chang) ； 陳永娟(Yong-Chuan Chen) ； 黃惠美(Hui-Mei Huang) ； 侯慧明(Hui-Ming Hou) ； 張玉女(Yu-Nu Chang) ； 楊毓秋(Yu-Chiu Yang) ； 洪玉玲(Yu-Lin Hung)

《榮總護理》 33卷3期 (2016/09) Pp. 303-311

https://doi.org/10.6142/VGHN.33.3.303

摘要

資訊化病人分類作業系統是依病人的疾病嚴重度設計的一種治療性措施計分系統，以病人治療性措施項目，換算成每日需要的護理時數，作為護理人力分派之參考。本單位經現況分析發現：找不到合適選項、教育訓練不足、不知該輸入哪一項、缺少查核機制等四項原因，致使護理人員輸入資訊化病人分類不正確率高達13.27%。本專案目的為降低新生兒加護病房護理人員輸入資訊化病人分類不正確率，期能正確呈現護理工作時數及人力分派。透過舉辦在職教育、增加資訊化病人分類選項、修訂資訊化病人分類配套組合、修訂學習護照、新訂資訊化病人分類輸入標準化作業、落實查核機制，降低護理人員輸入資訊化病人分類輸入不正確率至2.56%，可作為臨床照護個案分派及護理人力配置的依據。

關鍵字

資訊化病人分類 ； 新生兒加護病房

並列摘要

Patient classification is a critical method for determining nursing workforce requirements. This project employed the Patient Classification Information Technology System, which was established according to the patient disease severity assessment tool, the Therapeutic Intervention Scoring System (TISS), in which we found a mismatch between the therapeutic activities and nursing records input by nurses in the neonatal intensive care unit. Possible reasons for the record mismatch are as follows: (1) no optimal choice was available, (2) a lack of training, (3) an appropriate choice conld not be made, and (4) a lack of an internal control process. Therefore, we proposed solving this problem through the following methods: (1) deliver training programs to nursing units, (2) upgrade the Patient Classification Information Technology System for availability of optimal choices, (3) upgrade the Patient Classification Information Technology System to have multiple package choices for multiple-symptom patients, (4) upgrade learning passport implementation, (5) establish a standard operating procedure for the Patient Classification Information Technology System, and (6) establish an internal control monitoring process. Consequently, the neonatal intensive care unit nurses' incorrect input rate fell to 2.56% from 13.27% in the Patient Classification Information Technology System. We believe that this project could assist in accurate estimation for forecasting nursing hours and workforce needs, and be a foundation for nursing staffing arrangement in clinical care case assignments.

並列關鍵字

patient classifi cation information technology system ； neonatal intensive care unit

參考文獻

李卓倫、紀駿輝、徐明儀(2013)‧ 病人安全與護理人力配置‧ 護理雜誌，60(2)，19-23。doi: 10.6224/jn.60.2.19

張麗銀、林麗英、余幸澄、盧小玨、張美玉(2009)‧ 運用治療性措施計分系統建構加護病房之病人分類‧榮總護理， 26(4)，324-335。doi: 10.6142/VGHN.26.4.324

張麗銀、林麗英、盧小玨、王曼溪、張美玉(2002)‧ 加護病房治療性措施計分系統與護理人員活動之關係初探‧榮總護理，19(3)，254-263。doi: 10.6142/VGHN.19.3.254

Cullen, D. J., Civetta, J. M., Briggs, B. A, & Ferrara, L. C. (1974). Therapeutic intervention scoring system: A method for quantitative comparison of patient care. Critical Care Medicine, 2(2), 57-60. doi: 10.1097/00003246-197403000-00001

Dal Sasso, G. M., & Barra, D. C. (2015). Cognitive workload of computerized nursing process in intensive care units. Computers, Informatics, Nursing, 33(8), 339-345. doi: 10.1097/CIN.0000000000000157