提升急診重症區病人護理交班作業完整率

護理交班是延續照護的溝通過程，完整的訊息傳遞、提供持續性的照護是護理人員的責任與義務。本單位2019年重症區護理交班作業完整率僅79.5％，引發病安問題、家屬抱怨及同仁間仇視等事件，故成立專案小組研擬對策。運用制定急診交班單格式、交班標準作業流程、規劃稽核模式及教育訓練、製作急診常見疾病教戰手冊及增設交班尖峰時段之機動小組。專案施行後，急診重症區護理交班作業完整率由79.5％提升至95.6％，滿意度由51.4％提升至82.6％，平均總交班時間由87.6分鐘減少為33.6分鐘，達專案改善目的。建議未來制定資訊化交班模式，減少因人工作業的錯誤，更可縮短傳統口述交班的時間，提升護理照護品質及病人安全。

關鍵字

急診；護理交班；完整率

並列摘要

Nursing shift change report, handover, is a communication process of continuing healthcare. Complete message transmission and providing continuous healthcare are the responsibilities and duties of a registered nurse. Survey of the studied intensive care unit in 2019 indicated that only 79.5% completed handover report which raised patient safety concerns, patient/family complaints, and frictions among colleagues. A task force was established to develop countermeasures. The resolution include the use of an emergency department handover form, established a standard operating procedure for handover, developed a handbook of common disease for patients in the emergency room, and setup an internal audit, education, training, and peak time mobile team. After the implementation of the measures, the handover integrality rate of nurses in the critical intensive care area increased from 79.5% to 95.6%, patient/family satisfaction increased from 51.4% to 82.6%, and the average total handover time was reduced from 87.6 minutes to 33.6 minutes. Future recommendations included the developing of a computerized shift handover procedure to reduce human errors, further reduce handover time, and improve the quality of nursing care and patient safety.

並列關鍵字

emergency department ； nursing handover ； integrity rate

參考文獻

陳怡惠、李明珠、陳秀敏、蔡惠婷、陳萃婷 (2017) ，護理人員交班內容一致性改善專案，健康與建築雜誌，4 (1)，42-50。https://doi.org/10.6299/JHA.2017.4.1.R5.42

鍾杜珍、石偉廷 (2018) 提升急診護理師交班作業完整率，領導護理，19 (4)，103-115。https://doi.org/10.29494/LN.201812_19(4).0008

莊麗玉、李建 (2009) 交班-護理人員溝通，護理雜誌，56 (3)，93-97。https://doi.org/10.6224/in.56.3.93

Ernst, K. M., McComb, S. A., & Ley, C. (2018). Nurse-to-nurse shift handoffs on medical-surgical units: A process within the flow of nursing care. Journal of Clinical Nursing, 27 (5-6), e1189-e1201. https://doi.org/10.1111/jocn.14254

Poletick, E. B., & Holly, C. (2010). A systematic review of nurses' inter-shift handoff reports in acute care hospitals. JBI Library of Systematic Reviews, 8 (4), 121-172. https://doi.org/10.11124/01938924-201008040-00001

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