運用持續品質改善策略於約束帶創新

Innovate Restraints by Continuous Quality Improvement Strategy

王麒嘉(Ji-Ja Wang) ； 廖淑貞(Shu-Chen Liao) ； 洪世欣(Shih-Hsin Hung)

《健康與建築雜誌》 3卷1期 (2016/02) Pp. 53-58

https://doi.org/10.6299/JHA.2016.3.1.R7.53

摘要

目的：運用持續性品質改善步驟，進行約束帶改良，提升病人安全。方法：利用乒乓球手套、手腕式約束帶、雙向式拉鍊、磁扣組、S腰帶，以持續性品質改善概念應用於本方案，改良出微笑磁扣手套。結果：微笑磁扣手套的六大變革符合三大特性：(1)安全：以磁扣方式固定於床體強化約束安全；(2)舒適：手套及約束帶合成為一體避免滑脫；手套依病人手掌大小區分尺寸；手背指尖處立體式剪裁，讓手指有伸展的空間提升病人舒適性；(3)符合醫療需求：指尖雙開式拉鍊設計便於開合監測指尖血糖或血氧值；拉鍊設計方便清洗時可將鐵板取下，提升布料及拉鍊的使用壽命、落實終期消毒。結論/實務應用：微笑磁扣手套能有效提升病人的安全、舒適性並符合醫療需求，更能提升護理師及病人家屬之使用滿意度，病人家屬對約束之滿意度由41分提昇到96分；護理師對約束工具之滿意度由61分提昇到97.5分。

關鍵字

身體約束 ； 病人安全 ； 磁扣

並列摘要

Purposes: Restraint strap is modified by using continuous quality improvement strategies in order to promote patient's safety. Methods: The concept of continuous quality improvement was used in this plan to modify ＂the smile magnet hook gloves＂. Some items, such as gloves, the wrist restraint strap, double-opened zipper, magnet hook, and S belt, were used in this plan to produce one new tool. Results: There were six changes of the smile magnet hook gloves which commit three characters: 1) safety: magnet hook was used to fasten on the bed for strengthen the restraint safety, 2) comfort: gloves and restraint strap were combined together to avoid glide from the hands. The gloves have different size to fit the patient’s palm. The finger part of the gloves was constructed by 3D cutting which can fit the fingers having more space for stretching. 3). fitting medical needs: the zipper in the finger part was double-open type, which can be easily opened and closed to check finger blood sugar and oxygen saturation. Also, the iron plate can be easily removed from the gloves, which can let the gloves sterilizing properly and prolong the using period. Conclusions/Implications for Practice: The smile magnet hook gloves can contribute patient's safety and comfort. According to the data, there was significant increase in family's satisfaction from 41 points to 96 points. And, the same trend in nurse's satisfaction was raised from 61 points to 97.5 points. The result is not only fit the medical needs, but also raise the satisfaction both of nurses and patients’ family.

並列關鍵字

physical restraints ； patient safety ； magnet hook