降低內科病房白班人員延遲下班之改善專案

護理人員是醫療團隊中不可或缺的成員，研究顯示護理人員延遲下班率極高，超過負荷的工作量導致延遲下班、長期體力透支造成護理人員身心等問題，本病房常延遲下班造成身心疲憊、照護品質不佳等，故引發動機。自2018年6月至8月延遲下班率為89.8%與88.2分鐘／每班。發現問題有下午出院比例高，以致交接班接新病人；給藥與書寫護理紀錄費時；交班內容繁瑣耗時；施打靜脈留置針費時與庶務性工作多。故推動今辦明出規範、交接班迎接新病人SOP、護理紀錄書寫規範、施打靜脈留置針求援機制、修訂資訊給藥系統與護理助理師工作職責、運用ISBAR簡化交班方式與內容。實施後延遲下班率由89.8%降32.8%，平均時間由88.2分鐘降為28.2分鐘，藉此供其他單位參考。

關鍵字

內科病房；護理人員；延遲下班

並列摘要

Nursing staff play an indispensable role in the medical team. Studies have shown that the rate of delay in going off-duty is extremely high. Excessive workload is a cause of delayed off-duty, and the resulting long-term physical exhaustion causes physical and mental problems for nursing staff. On the ward discussed in this report nursing staff are often late to leave work, causing physical and mental exhaustion, poor quality of care, and related problems. From June to August 2018, the delayed off-duty rate was 89.8% and 88.2 minutes per shift. Problems identified as contributing to this delay were: the rate of discharge in the afternoon was so high that new patients were handed over; medication and nursing records were time-consuming; the content of the shift was cumbersome and time-consuming; the administration of intravenous indwelling needles was time-consuming; and a lot of general work. To address these issues, this report evaluated and recommends a number of steps: clarify the specifications of patient discharge; SOPs to handover new patients when transfer shifts; write norms for nursing records; provide an assistance mechanism during administering intravenous indwelling needles; revise the information delivery system and the duties of nursing assistants; and use ISBAR to simplify the way and content of shifts. After the implementation of the above steps, the delayed off-duty rate was reduced from 89.8% to 32.8%, and the average time was reduced from 88.2 minutes to 28.2 minutes, which was taken for the reference by other units.

並列關鍵字

medical wards ； nursing staff ； work overtime

參考文獻

柯雅婷、王秀紅、許素珍(2016)．運用組織轉變改善護理人員延遲下班問題．領導護理，17(4)，58-70。https://doi.org/10.29494/LN.201612_17(4).0006

陳秋曲、林詣茜、郭志強、陳瓊瑤、林玉如(2019)．降低肝膽腸胃科病房非計畫性週邊靜脈留置針重注率之改善專案．榮總護理，36 (2)，143-151。https://doi.org/10.6142/VGHN.201906_36(2).0004

黃詩淳、許霈欣、沈淑蕙、葉素娥、胡瑞桃(2018)．提升門診外科病人白班住院比率．新臺北護理期刊，20(1)，65-76。https://doi.org/10.6540/NTJN.2018.1.006

郭嘉琪、馮已榕、李維鈞(2017)．近紅外線設備輔助兒童周邊靜脈注射之效應—系統性文獻回顧與次族群統合分析．護理雜誌，64(5)，69-80。https://doi.org/10.6224/JN.000070

蕭如茵、楊純怡、李月妙、蘇佩真(2019)．運用Input-Throughput-Output model改善急診壅塞專案．高雄護理雜誌，36(1)，24-34。https://doi.org/ 10.6692/KJN.201904-36(1).0003

國際替代計量

降低內科病房白班人員延遲下班之改善專案

全文下載

主題瀏覽