縮短急重難症病童轉院流程準備時間

Shortening the Preparing Time for Transfer of Critically Ill Children

范綱翔(Kang-Hsiang Fan) ； 范圭玲(Guei-Ling Fann) ； 顏廷聿(Ting-Yu Yen) ； 李孟旃(Meng-Chang Lee) ； 陳宗虢(Tsung-Kuo Chen) ； 曹伯年(Po-Nien Tsao) ； 黃筱芳(Hsiao-Fang Huang) ； 温淑如(Shu-Ru Uen)

《台灣醫學》 25卷1期 (2021/01) Pp. 136-150

https://doi.org/10.6320/FJM.202101_25(1).0015

摘要

台灣兒科重症轉診沒有制度化的調派平台，且有時轉送過程狀況惡化，來到本院時需要急救或葉克膜處理。研究顯示在非專業轉院團隊轉送發生異常事件比率為61.0％，故由受過兒科重症醫學訓練的團隊來轉送病童是非常重要的。本案旨在縮短急重難症病童轉院流程準備時間，準備時間長之主因為：對流程不熟悉、對設備操作能力不足、外接用物設備分散於不同樓層、儀器設備不穩定、因病童年齡層不同致備物標準不一致、未有專用電梯。改善措施：舉辦在職教育訓練、宣導及建立標準作業流程、舉辦團隊資源管理訓練課程、建立流程查檢表、備物套裝化、採購新的儀器。結果：轉院流程準備時間由41.0分鐘下降24.9分鐘，有效縮短準備時間及提升轉診照護品質。

關鍵字

急重難症病童 ； 轉院流程準備時間 ； 轉院團隊

並列摘要

Taiwan lacks institutionalized dispatch platform for transfer of critically ill children. Sometimes it leads to more serious situations, namely CPR and the demanding of Extracorporeal Membrane Oxygenation (ECMO) when their conditions deteriorate during the transportation. Based on the research, the incidence rate of unplanned events was 61.0% for non-professional transfer team during the delivery process. Therefore, it is very important to transfer ill children by a well-trained team. This essay aims to shorten the preparing time for transfer of critically ill children. The reasons of long preparing time are unfamiliar transfer process, inability of equipment operation, equipment are placed on different floors, the unstable equipment, inconsistent standards of preparation for different ages and diseases, and a waste of time due to no dedicated elevator. The improvement strategies included: Education to strengthen relevant abilities, establishing standard operating procedures, establishing the training program of team resource management, making the procedure checklist, preparing the set suitable for transfer patient in advance, updating equipment. Result: Preparing time for transfer shortened from 41.0 minutes to 24.9 minutes, which effectively improved the quality of care.

並列關鍵字

critically ill children ； preparing time for transfer ； transfer team

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