運用團隊資源管理提升某口腔顎面外科病房電子醫護交班執行率

Improving the Completion Rate of Electronic Change-of-Shift Reports with Team Resource Management in an Oral and Maxillofacial Surgery Ward

吳杼芸(Ju-Yun Wu) ； 吳芷睿(Chih-Jui Wu) ； 黃君維(Chun-Wei Huang) ； 胡悛愉(Chuan-Yu Hu)

《台灣專科護理師學刊》 5卷1期 (2018/07) Pp. 47-57

摘要

背景：醫護交班訊息正確傳遞對維護病人安全之重要性是無可置喙的。經專案組員調查發現醫護交班執行率僅5.44 %，分析原因為不清楚交班規範、忘記交班、工作太忙、下刀時已超過交班時間、醫師未執行電子交班以致護理師無法回覆、醫護交班規範細則訂定不明確。目的：提升醫護交班執行率達≥ 90%。解決方案：運用團隊資源管理的概念擬定交班改善方案，內容包括制訂醫護交班訊息規範、交班標準作業流程及稽核規範、舉辦在職教育及說明會、成立關懷小天使計劃。結果評值：醫護交班執行率由5.44 %提升為98.20 %。結論：經改善方案實施後電子化溝通模式可有效提升醫護溝通傳遞即時及正確性，進而維護病人安全及提升病人照護品質。

關鍵字

團隊資源管理 ； 電子醫護交班 ； 交班

並列摘要

Background: Vital patient information being accurately handed over during a provider shift change is essential for the patient's safety. Prior to our project, we found that the completion rate of a change-of-shift report was only 5.44% and the reasons for incompletion included providers being unclear about shift report rules, forgetting to give a shift report, being too busy to give a shift report, delayed giving a shift report due to working on a surgical procedure, not being able to reply due to the electronic shift report documentation not fulfilled by a physician, and lack of clarity in the shift report regulations. Purposes: The purpose of this project was to increase completion rate of change-of-shift report up to 90%. Methods: We developed the change-of-shift report improvement project using the team resource management concept. The project included establishing rules on the required contents to be included in a change-of-shift report, standardized procedure for a change-of-shift report, and regulations for evaluation. We also conducted on-the-job trainings and formed a reward and punishment system (named Little Angel Program) to implement our change-of-shift report project. Result: The completion rate of change-of-shift reports increased from 5.44% to 98.20%. Conclusion: The project was able to improve the promptness and accuracy of communication among medical staff by using electrical change-of-shift reports, which ensures patient safety and increases the quality of patient care.

並列關鍵字

Team Resource Management (TRM) ； Electrical Change-of-shift Report ； Shift Report

參考文獻

徐慧興、張世琦、潘靜怡、劉曉雲 (2014).運用團隊資源管理提升外科病房醫護團隊之訊息連結及值班滿意度,醫務管理期刊,15(4),277-289。doi:10.6174/ JHM2014.15(4).277

黃璉華、黃嗣菜(2013).病人安全是醫療照護之首要，護理雜誌 • 60 (2)， 13-18 • doi:10.6224/JN.60.2.13

Blouin, A. S. (2011). Improving hand-off communications: new solutions for nurses. Journal of Nursing Care Quality, 26(2), 97-100. doi:10.1097/NCQ.0b013e31820d4f57

Deering, S., Johnston, L. C., & Colacchio, K. (2011). Multi- disciplinary teamwork and communication training. Sem- inars in Perinatology, 35(2), 89-96. doi:10.1053/j.sem- peri.2011.01.009

Russ, S., Rout, S., Sevdalis, N., Moorthy, K., Darzi A., & Vin- cent, C. (2013). Do safety checklists improve teamwork and communication in the operating room? A systematic review. Annals of Surgery, 258(6), 856-871. doi:10.1097/SLA.0000000000000206