- 期刊
- OpenAccess
某醫學中心降低非計劃性急診返診之改善專案
A Project of Decreasing Unplanned Emergency Depatment Revisit Rate in a Medical Center
摘要
非計劃性急診返診率是監控急診照護品質指標的其中一項，非計劃性急診返診的問題會造成急診資源的耗用以及醫療照護成本增加。急診醫護人員在面對非計劃性返診病患時，除了要處理病人生理上的不適外，還要面對處理不當可能引發的法律問題。由於單位非計劃性返診率高於醫策會所訂定的標凖值，因此藉由急診醫療系統的統計資料、回溯性查閱病歷法及訪談本單位的急診護理人員等方式，收集72小時非計劃性返診279位病人的相關資料，發現急診出院衛教指導完整性不足以及缺乏急診病患出院後追蹤規範爲主要問題，本專案選譯急診常見的出院診斷－急性腸冑炎病患，藉由製定急診出院病人電話訪問作業標率，追蹤急診出院病患病程之發展，在電話訪問過程中再次提供相關衛教，補弦急診出院衛教完整性欠缺之問題，以期有效地降低不公要的非計劃性急診返診率。專案成果顯示非計劃性急性腸胃炎病人返診率由專案前的5.38%降低爲專案後的3.4%，病人及家屬對出院電話訪問追蹤的滿意度爲82.61%，並表示對出院電話訪問肯定，以及提到需持續執行，這項措施在病人及家屬返家後的焦慮或不確定感之問題有正向的助益。因此建議持續推廣急診出院病患電訪作業及追蹤病情發展之作業模式，可確保急診醫療服務品質，並提高急診病患照護的滿意度。
並列摘要
Unplanned emergency department (ED) revisit rate is an indicator of quality of care in the ED. The patients' frequent return to the ED results in a waste of emergency medical resource and may increase medical cost in turn. While dealing with unplanned revisit patients, ED nurses have to deal with both the patients' physical problems and the related legal issues. The revisit rate in the ED where the authors worked at was higher than the standard rate. The authors found that the main factors for the problem were a lack of standard process of discharge follow-up and incomplete patient education. Therefore, a standard process including telephone interview, patient' medical condition follow-up, and discharge patient education was developed and administered. The result demonstrated that satisfaction rate of discharge telephone follow-up was 82.61% while the unplanned ED revisit rate decreased from 5.38% to 3.3%. The patients and their family suggested that discharge telephone follow-up was good for them and should be continuously provided because it helped to deal with patients' uncertainty and anxiety after discharge. Overall, the study revealed that a standard telephone interview to ED discharge patients could ensure the quality of ED care and increase the satisfaction of the patients.
被引用紀錄
延伸閱讀
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