運用ECRS策略改善大腸直腸外科病房護理人員交班耗時

護理人員交班耗時會造成逾時下班及治療延遲，進而影響工作滿意度及照護品質。本專案旨在運用ECRS策略改善大腸直腸外科病房護理人員交班耗時，發現問題為跨段落交班需等待、交班重點及順序不一、電腦資訊交班畫面頻繁切換、交班過程因接班者詢問中斷、跟醫師查房中斷交班、未規範交班內容書寫順序、缺乏專科應交班項目及電腦資訊系統交班項目缺乏統一順序。於2021年2月1日到6月20日透過規劃專科交班內容、建構新式交班作業模式、規劃班表人力、訂定中斷交班處理原則及舉辦新式交班作業教育訓練，交班時間由30.7分降至12.0分，交班滿意度由64.3%提升至91.7%，本專案結果有效降低護理人員交班耗時，可平行推行其它病房使用，共同維護病人安全與提供友善職場環境，也讓醫護人員將更多時間專注於臨床照護病人。

關鍵字

ECRS策略；大腸直腸外科病房；交班耗時

並列摘要

The time that nursing staff spend performing handovers can lead to overtime work and treatment delays, subsequently impacting job satisfaction and quality of care. This project aims to apply the Eliminate, Combine, Rearrange, and Simplify (ECRS) strategy to reduce handover time for nursing staff in a colorectal surgery ward. Identified issues include waiting during cross-segment handovers, inconsistent handover priorities and sequence, frequent switching of computer information pages, interruptions from incoming nurses during the handover process, interruptions during doctor rounds, lack of standardized sequence for handover written content, insufficient specialized handover tasks, and a lack of uniformity in the sequence of computer information system handover tasks. From February 1 to June 20, 2021, the following measures were implemented: crafting specialized handover content, developing a new handover operating model, planning employee schedules, establishing guidelines for handling interruptions during handovers, and conducting training sessions on the new handover operations. As a result, the handover time was reduced from 30.7 minutes to 12.0 minutes, and handover satisfaction increased from 64.3% to 91.7%. The project effectively reduced the time that nursing staff spend performing handovers, offering a model that can be implemented concurrently in other wards. This helps ensure patient safety, creates a more supportive work environment, and allows healthcare professionals to put greater focus on patient care.

並列關鍵字

ECRS ； Colorectal Surgery Ward ； Clinical Handover Time

參考文獻

侯玉純、林素美、陳瓊汝、徐金民、楊慶晨、簡淑珍、廖佳慧、鄭瑞楠、簡惠萍（2020）．剔除、合併、重排、簡化(ECRS)手法縮短新生兒加護病房共管備血時間．台灣醫學，24(5)，567-575。[Hou, Y.-C., Lin, S-M., Chen, C. J., Hsu,C.-M., Yang, C.-C., Chien, S.-Z., Liao, C.-H., Cheng, J.-N., & Chien, H.-P. (2020). Elimination, Combination, Rearrangement and Simplification (ECRS) Skills Shorten the Blood Preparation Time in Sharing Specimen in NeonatalIntensive Care Unit. Formosan Journal of Medicine , 24(5), 567-57] https://doi.org/10.6320/FJM.202009_24(5).0011

柯一青、林雨君（2019）．運用精實管理精神提高醫院工程預算執行率．工業安全衛生，(358)，40-57。[Ke, Y.-Q., Lin, Y.-J. (2019). Use Lean Management Spirit to Improve Hospital Project Budget Execution Rate, Industrial Safety and Health, (358), 40-57.] https://doi.org/10.6311/ISHM.201904_(358).0006

胡雅潔、呂彥儀、徐雯娟（2023）．運用精實管理改善外科加護病房交班耗時．台灣醫學，27(4)，520-529。Hu, Y.- J., Lu, Y.-Yi., & Hsu, W.-C. (2023). The Application of Lean Management to Improve Nursing Handover at Surgical Intensive Care Unit. Formosan Journal of Medicine, 27(4), 520-529.] https://doi.org/10.6320/FJM.202307_27(4).0016

郭旭展、魏品菁、張以智、洪翠妹、鄒淑萍（2020）．精實管理於精神科病房護理交接班之應用．護理雜誌，67(5)，65-73。[Kuo, H.-C., Wei, P.-C., Chang, Y.-C., Hung, T.-M., & Chou, S.-P. (2020). The utilization of lean management in nursing handover at a psychiatric acute ward. The Journal of Nursing, 67(5), 65–73.] https://doi.org/10.6224/JN.202010_67(5).09

陳慧華、陳秀吉、吳明珠、陳淑華、陳秀偵、金玉華（2021）．護理人員執行護理活動超工時之改善專案．長庚護理，32(2)，78-90。Chen, H.-H., Chen, H.-C. Wu , M. –C., Chen, S.-H., Chen, S.-C., & Chin, Y.-H. (2021) . An Improvement Project to Reduce Overtime Hours of Nursing Activities. Chang Gung Nursing, 32(2), 78-90.] https://doi.org/10.6386/CGN.202106_32(2).0007

延伸閱讀

全文下載

主題瀏覽