提升急診護理師交班作業完整率

Improving the Integrality of ER Nursing Handover

鍾杜珍(Tu-Chen Chung) ； 石偉廷(Wei-Ting Shih)

《領導護理》 19卷4期 (2018/12) Pp. 103-115

https://doi.org/10.29494/LN.201812_19(4).0008

摘要

本單位為區域醫院之急診室，2015年第一季急診交班摘要單紀錄完整率，由2014年90.5%驟降為78.9%，且各病房因急診護理師交班不完整而投訴的抱怨事件遽增，甚至陸續有影響病人安全的事件陸續傳出，故引發改善單位交班作業完整率之動機，並成立專案小組研擬對策。運用修定標準作業流程、簡化交班摘要單、增加合理護理人力、醫療報告資訊化、規劃教育訓練及制定稽核制度，提升急診護理師交班作業完整率由76.4%到93.1%，急診交班摘要單紀錄完整率由78.9%提升到91.2%及急診交班作業認知正確率由62.7%提升到88.7%完成專案目的。建議全院制定交班資訊化，提供病人快速、正確的就醫資訊，進而提高單位間交班和諧，減低抱怨事件，維護醫療照顧的持續性及病人安全，促進更優質的專業護理照護。

關鍵字

護理交班 ； 急診 ； 完整率

並列摘要

In an emergency department of a regional hospital, the integrality of nursing handover process plummeted from 90.5% in the first quarter of 2014 to 78.9% in the first quarter of 2015. The complaints from ward nurses increased dramatically due to incomplete shift handover from emergency department. Furthermore, several avoidable adverse events occurred one after another. Consequently, the researchers are motivated to improve the integrality of nursing handover and to set up an ad hoc group formulating appropriate as well as effective policies. In order to complete this mission, the researchers improved the nursing handover integrality rate in emergency department from 76.4% to 93.1%. The integrality rate of nursing handover summary increases from 78.9% to 91.2%, and the accuracy of nursing handover increases from 62.7% to 88.7% by amending standard operating procedure, simplifying handover summary, increasing reasonable nursing manpower, computerizing medical reports, plan a system of training and auditing. This study proposed the system of computerizing nursing handover to provide accurate patient information. Furthermore, nursing handover between departments will be more harmoniously, and professional nursing care will result in higher quality.

並列關鍵字

Nursing handovers ； Emergency department ； Integrity rate

參考文獻

李雨庭、張雅萍、張春鳳、李嘉琪、賴東玲（2017）‧運用跨團隊模式提升緊急手術醫護交班之完整率‧馬偕護理雜誌，11(2)，24-35。doi：10.29415/JMKN.201707_11(2).0003

陳怡潓、李明珠 、陳秀敏 、蔡惠婷、陳萃婷（2017）‧護理人員交班內容一致性改善專案‧健康與建築雜誌，4(1)，42-50。doi: 10.6299/JHA.2017.4.1.R5.42

陳欣伶、陳國智、侯勝茂、邱浩彰、吳鋼治、王宗倫、柯威旭、張嘉宇、鄭瑞楠、宋佳樺、廖若雯（2013）‧運用團隊資源管理建置病房交班制度‧台灣醫學，17(1)，70-75。doi：10.6320/FJM.2013.17(1).11

莊麗玉、李建德（2009）‧交班-護理人員溝通‧護理雜誌，56(3)，93-97。doi：10.6224/JN.56.3.93

王美玉、鄭秀瑮（2015）‧改善急診與加護病房交接班安全‧醫院雙月刊，48(1)，57-67。