提升急診重症病患轉入加護病房交班完整率

Promoting the Complete Transfer of Emergency Room Patients to the Intensive Care Unit during a Change-of-shift Report

蔡佳樺(Chia-Hwa Tsai) ； 李金媛(Chin-Yuan Li) ； 邱文旗(Wen-Chi Chiu) ； 徐玉枝(Yu-Zhi Hsu) ； 洪珮娟(Pei-Chuan Hung) ； 歐玉雯(Yu-Wen Ou)

《北市醫學雜誌》 5卷6_S期 (2008/12) Pp. 673-682

https://doi.org/10.6200/TCMJ.2008.5.6.11

摘要

某區域醫院由急診室轉入加護病房病患，佔加護病房住院總人數52.43%，而急診室病患轉入加護病房交班平均完整率僅為69.49%。為改善此狀況，專案小組針對交班不完整的原因進行分析。分析結果發現：造成交班不完整的原因為無制式交班指引單；以翻閱病歷方式交班；未宣導交班完整重要性；對交班內容認知不同。故擬訂對策為召開共識會議，發展急診室重症病患轉入加護病房交班指引單、利用交班指引單進行交班。結果顯示在使用交班指引單後，交班平均完整率由69.49%提升至90.90%。

關鍵字

急診 ； 護理交班單 ； 病人安全

並列摘要

In a regional hospital, the patients who were transferred from the emergency room to the intensive care unit (ICU) accounted for 52.43% of the total patients staying in the ICU, but the patients in the emergency room who were transferred to the ICU accounted for only 69.49% based on an average complete change of shift. To improve this condition, a special committee was formed to analyze the causes of this incomplete change of shifts. Their investigations showed that there was no standard form used in shift changes and, because only patient's resumes were used, this resulted in an incomplete exchange of information from one nurse to another. In addition, the idea of the importance of changing shifts efficiently was not promoted so that the staff had different views about what should be done. Therefore, the solution was to convene a consensus meeting with the aim of making a standard instruction form for ward shifts. This would be used not only for the very sick patients being transferred from the emergency room to the ICU but also to change shifts. The results showed that the average complete rate of shift change rose from 69.49% to 90.90% after using the standard instruction form for ward shifts.

並列關鍵字

emergency room ； intensive care unit ； change of shift ； exchange of information