降低呼吸照護病房照顧服務員異常事件之改善方案

照顧服務員為長期照護體系中，直接照顧病患重要的一環，影響病患安全甚鉅。本專案於2006年採資料回溯，分析2005年某呼吸照護病房6件照顧異常事件，甚至與2名病患死亡相關。因此，降低照顧異常事件實刻不容緩，本專案問題為異常事件發生件數0.5件／月，其主要導因為：護理人員欠缺指導照顧服務員能力；照顧服務員知能不足、缺乏正確倫理及工作理念；未制訂照顧工作標準；院方及照顧服務員協會未具完善管理、品質稽核制度與教育訓練。藉由照顧服務員與護理人員教育訓練、制定照顧工作標準、建立照顧品質稽核及管理制度等介入措施，結果發現2007年異常事件由改善前0.5件／月降低為0.1件／月，優於原定目標之0.23件／月，其中致命性傷害由33%降至0%。照顧服務員服務滿意度由63.7%提升至82.1%、護理人員每班輔導管理照顧服務員時數由135分鐘降至21.1分鐘，抱怨件數由3.5件／月降低至2件／月，落實病患照顧安全。

關鍵字

照顧服務員；照顧異常事件；長期照護機構

並列摘要

The nurse aide plays an important role in the long-term care system by providing direct care having tremendous impact on patients' safety. The retrospective data analyzed in 2006 has shown that there were six incidents in the respiratory care ward (RCW) in 2005 caused by inappropriate care provided by nurse aides. Therefore, it's crucial to reduce these incidents caused by inappropriate nurse aides. It was found by this project that the causes of these incidents include: the nursing staffs are incapable of conducting the nurse aides; the nurse aides do not have enough knowledge in patient care nor ethics at work; the standard caring procedures are not sufficiently provided; the administrative system, the auditing system for quality of care, and training of nursing aides are not well organized. By means of the implementation of continuing education, the formulation of standard operation process of nursing care, and the establishment of care quality monitoring system, the incident rates dropped from 0.5 to 0.1 per month by the end of 2007, which was better than the goal of 0.23 per month, and the fatal injuries dropped from 33% to 0%. On the other hand, the satisfaction of care and service quality increased from 63.7% to 82.1% in 2007; the time spent on managing the incidents was reduced from 135 minutes to 21.1 minutes; and the patient complaints was reduced from 3.5 to 2 cases per month which indicate both of the safety and quality issues were accomplished.

並列關鍵字

nurse aide ； incident events ； long-term care facility

國際替代計量

降低呼吸照護病房照顧服務員異常事件之改善方案

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