精神科急診病患就醫及住院流程改善方案

A Program to Improve the Process of Outpatient Visits and Hospitalization for Psychiatric Patients

黃美玲(Mei-Ling Huang) ； 邱飄逸(Piao-Yi Chiou)

《精神衛生護理雜誌》 2卷1期 (2007/03) Pp. 51-59

https://doi.org/10.6847/TJPMHN.200703_2(1).0008

摘要

在精神科急診病患就醫與住院流程中，病患與家屬常因等待時間過久，而產生負向情緒反應，導致護病衝突，造成人力、物力消耗並增加護理人員工作負荷與壓力。本專案之目的為：1.減少精神科急診就醫與住院作業流程時間；2.降低急診病患及家屬對就醫與住院之困擾程度；3.降低護理人員對急診病患就醫與住院之困擾程度。分析導致精神科急診病患就醫與住院流程等候時間過久之問題與原因，確立主要改善措施為：建立新的精神科急診就醫與住院標準流程，同時簡化急診病患作業單張；經溝通與建立共識後，急診病患優先簽住院床，並於30分鐘內由專門人員護送急診病患住院，護理人員則以電話方式交班；建立第二線急診醫師支援系統。結果顯示作業流程時間由每人平均1051分鐘降低為522分鐘，病患與家屬困擾程度平均降低1.6分，工作人員困擾程度平均降低1.9分，皆已達專案設定之目的。專案結果可作為精神科急診就醫與住院流程管理之參考。

關鍵字

精神科急診 ； 就醫 ； 住院流程

並列摘要

During the process of outpatient visits by or hospitalization of psychiatric patients, disputes between patients and medical staff often result from patients' and their families' emotional reactions to long waits in psychiatric emergency departments, which can waste manpower and resources. The purpose of this program was to reduce the length of time required for emergency visits and the hospitalization process, in order to reduce the levels of distress experienced by patients and their families, and by medical staff. After analyzing the problems and the reasons for them, we established the following measures to deal with them: set up a new standard procedure for psychiatric patients' outpatient visits and hospitalization; simplified emergency record keeping; consulted fully and established a common consensus that emergency patients are the first priority in the allocation of beds in the psychiatric ward, that patients will be taken to the psychiatric ward by special escorts within 30 minutes of notice from emergency and that emergency nurses will report patient information to the ward by telephone. A secondary emergency doctor support system was also established. The results indicated that the time required for emergency visits and the hospitalization process could be decreased from 1051 to 522 minutes per person, and that the distress levels of patients and their families decreased to 1.6 and that of medical staff to 1.9. These results might serve as a reference in psychiatric emergency operation management.

並列關鍵字

psychiatric emergency ； outpatient visit ； hospitalization process