提升恢復室護理師危症應變執行完整率

恢復室護理師最主要的功能是重建麻醉後病人生理平衡狀態，讓手術後病人自麻醉中安全清醒，人員需要具備在短時間內及早發現病人有危症情況的能力，透過醫療團隊快速的介入，提供有效的適當措施，才能有效降低病人入住加護病房及減少急救事件發生。在臨床照護中，麻醉部對於恢復室危症應變過程中處置流暢度不佳，溝通協調不滿意，要求需進行應變的檢討改善，引發改善動機，經現況調查危症應變執行完整率僅達77.2%；危症應變認知正確率總平均為63.3%。主要因為危症應變成員職責分配不明確、沒有明確領導者、支援的麻醉技師不熟悉恢復室的環境、缺乏危症及用藥的在職教育訓練課程、危症應變模擬演練及檢討機制等因素造成完整率低。透過舉辦危症應變作業教育訓練課程及高擬真情境模擬訓練、制訂危症應變成員職責分配及角色配置圖、每次危症應變後安排檢討會和製作危症藥物稀釋比例旋轉盤等策略改善。改善後，恢復室護理師危症應變執行完整率提升至平均97.8%；危症應變認知正確率提升至90%，達專案目的。藉由專案進行提升恢復室護理師危症應變熟悉度及完整性，同時也強化團隊合作流暢度，提升整理照護品質。

關鍵字

恢復室；危症應變；執行完整率

並列摘要

The main function of the nurse in the recovery room is to restore the physiological balance of the patient after anesthesia, so that the patient can wake up safely from anesthesia after the operation. The personnel need to have the ability to detect the critical condition of the patient early in a short period of time, and quickly intervene through the medical team. Only by providing effective and appropriate measures can we effectively reduce the number of patients admitted to the intensive care unit and the occurrence of emergency incidents. In clinical care, the anesthesia department has poor handling fluency and unsatisfactory communication and coordination in the process of recovering from ventricular emergency response. It requires review and improvement of emergency response, which arouses motivation for improvement. According to the situation survey, the completion rate of critical emergency response implementation was only 77.2%. The average correct rate of cognition of crisis response was 63.3%. It was mainly due to the unclear assignment of responsibilities of crisis response members, lack of a clear leader, supporting anesthesia technicians unfamiliar with the environment of the recovery room, and lack of on-the-job education and training courses on crisis and medication, crisis response simulation drills and review mechanisms to result in the low completion rate. The improvement was made through the organization of crisis response operation education and training courses and high-fidelity situation simulation training, the development of crisis response member responsibilities and role configuration maps, the arrangement of review meetings after each crisis response, and the production of crisis drug dilution ratio rotary disks and other strategic improvements. After the improvement, the completion rate of critical emergency response execution by nurses in the recovery room increased to an average of 97.8%; the correct rate of critical emergency response cognition increased to 90%, achieving the purpose of the project. Through the implementation of the project, the familiarity and completeness of critical emergency response of nurses in the recovery room improved, and the fluency of teamwork was also strengthened to improve the quality of care.

並列關鍵字

recovery room ； crisis response ； execution integrity rate

參考文獻

朱美春、詹淑惠、李惠珍、洪聖惠、吳永隆、許瑋庭（2018）‧結合團隊資源管理與情境模擬探討急診團隊急救訓練成效‧台灣擬真醫學教育期刊，5（2），4-16。https://doi.org/10.6582/JTSSH.201812_5(2).0001

李欣娜、何嘉莉、林榆絜、吳麗敏、王佳慧（2021）‧運用情境模擬提升血液透析護理師急救技能完整率‧臺灣腎臟護理學會雜誌，19（2），49 - 65。https://doi.org/10.3966/172674042020121902004

李心云、黃怡雅、林瑞香、徐雯娟（2020）‧提升胃腸肝膽科病房急救作業完整性‧台灣醫學，24（3），314-323。https://doi.org/ 10.6320/FJM.202005_24(3).0011

陳秀芳、賀倫惠、李香君、邱小鳳、陳海焦、蔡青青（2020）‧護理情境模擬教案設計-以重症護理課程為例‧長庚護理，31（3），338-353。https://doi.org/ 10.6386/CGN.202009_31(3).0004

劉慧玲（2020）‧重症病人病況惡化的早期警示系統‧護理雜誌，67（1），19-24。https://doi.org/10.6224/JN.202002_67(1).04

主題瀏覽