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提升重症單位護理人員對PiCCO判讀正確率

Improvement of the Accuracy Rate of PiCCO Assessment for ICU Nursing Staff

摘要


本專案旨在提升重症單位護理人員判讀PiCCO正確率,本單位常收置多重外傷合併敗血性休克病人,加上加護病房有許多儀器設備,若能有效進行數據分析,更能及時處置及防止惡化,因而引發專案小組進一步探討動機。經專案小組初期調查下,護理人員對PiCCO判讀正確率僅33.64%,發現護理人員對PiCCO判讀知能不足、缺乏相關在職教育、缺乏中文版PiCCO判讀工具及單位人員缺乏PiCCO指導一致性。經專案小組擬定舉辦在職教育課程及判讀PiCCO品質監測作業、製作判讀參閱本等策略,結果提升護理人員對PiCCO判讀正確率高達78.25%,本專案可平行推展至使用PiCCO之單位,進而提升護理人員判讀率及醫療照護品質。

並列摘要


The project aims to improve the accuracy rate of the Pulse Contour Cardiac Output (PiCCO) assessment for intensive care unit (ICU) nursing staff. The ICU accommodates patients with multiple traumas and septic shock, and several instruments are applied. Therefore, training regarding the ability to assess and analyze data is required to save time and prevent patient deterioration. The initial investigation of this study showed that the accuracy rate of the PiCCO assessment for the nursing staff was only 33.64% due to insufficient knowledge of PiCCO interpretation, lack of relevant in-service education, lack of the Chinese version of PiCCO interpretation tools, and the absence of PiCCO guidance consistency. The project group has planned the in-service education training, interpreted the PiCCO quality monitoring, and produced the PiCCO interpretation suggestions. Finally, the accuracy rate of the PiCCO assessment by the nursing staff reached 78.25%. This project contributes to providing practical suggestions on applying PiCCO and interpreting the assessment for other related medical units.

並列關鍵字

accuracy rate PiCCO septic shock

參考文獻


林珍瑋、王筱珮(2015).重症單位血液動力學監測器介紹.護理雜誌,63(1),117-124。https://doi.org/10.6224/JN.63.1.117。
Bognar, Z., Foldi, V., Rezman, B., Bogar, L. & Csontos, C. (2010). Extravascular lung water index as a sign of developing sepsis in burns. Burns, 36(8), 1263-1270. https://doi.org/10.1016/j.burns.2010.04.006。
Liu, X. Y., Ji W. L., Wang, J. F. & Pan, T. (2016). Application strategy of PiCCO in septic shock patients. Experimental and Therapeutic Medicine, 11 , 1335-1339. https://doi.org/10.3892/etm.2016.3040。
Song, J. E., Kim, M. H., Jeong, W. Y., Jung, I. Y., Oh, D. H., Kim, Y. C., Kim, E. J., Jeong, S. J., Ku, N. S., Kim. J. M., & Choi, J.Y. (2016) Mortality risk factors for patients with septic shock after implementation of the surviving sepsis campaign bundles. Infect Chemother, 48 (3), 199-208. https://doi.org/10.3947/ic.2016.48.3.199。
Zhang, W., Danzeng, Q., Feng, X., Cao, X., Chen, W., & Kang, Y. (2013) Sequential organ failure assessment predicts outcomes of pulse indicator contour continuous cardiac output-directed goal therapy. Medicine, 96 (39) p e8111. https://doi.org/10.1097/MD.0000000000008111。

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