縮短高危險妊娠孕婦緊急處置時間專案

本專案旨在縮短高危險妊娠孕婦急診之緊急處置時間，小組調查2013年1月至3月有41.9%高危險妊娠孕婦在急診就診後等待初步醫療處置時間長達40分鐘，遠超過本院急診照會須於30分鐘內診治病人之規範。分析原因為：婦產科醫師未分配團隊成員工作、急診護理師未確實評估及交班、照會流程繁瑣、他院醫護人員未事先通知孕婦狀況、求援機制不完善等。2013年1月至12月透過專案進行高危險妊娠急診就診流程再造、導入團隊資源管理於高危險妊娠照護改善。實施後將高危險妊娠孕婦緊急處置時間從40分鐘縮短為22.5分鐘，改善團隊合作默契與交班模式，縮短緊急處置時間並強化病人就醫安全。期望能藉此專案成果分享，造福更多高危險妊娠之個案，以共同守護母嬰安全。

關鍵字

醫療團隊資源管理；程序分析法；緊急照護；高危險妊娠

並列摘要

The purpose of this project is to shorten the waiting period between when high-risk pregnant women visit the ER and when they get treated. An investigating group revealed that from January 2013 through March 2013, 41.9% of high-risk pregnant women waited for 40 minutes at the ER before they were treated; this number exceeds the hospital's policy that emergency consults must be completed within 30 minutes. Further analysis indicated that the reasons for delay includes: Obstetricians failed to allocate work among team members, nursing staff at the ER did not accurately evaluate the patient or properly hand-over the patient, consultation procedures were overly complicated, patients were not informed of their conditions before transfer to ER, and procedures of asking for assistance were poorly standardized. Thus, from January 2013 through December 2013, process reengineering was used for ER visits of high-risk pregnant women and TRM was used to improve the quality of care of high-risk pregnancies. After implementation, the time of emergency management decreased from 40 minutes to 22.5 minutes. As a result, hospitalization safety was strengthened through improved teamwork, hand-off standards, and increased productivity of effective management. The result of this study is to benefit future care of high-risk pregnancies and to cooperatively secure both maternal and fetal care.

並列關鍵字

TRM ； ECRS ； Emergency management ； High risk pregnancies

國際替代計量

縮短高危險妊娠孕婦緊急處置時間專案

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