＂Let's Move It＂提升嚴重創傷病人早期復健達成率

近年文獻指出，於重症加護病房內執行早期活動介入，有許多益處。然而，針對創傷重症的病人，早期活動的介入，不僅執行困難度高，也缺乏明確的執行方式，因此激發本團隊進行「品質改善計劃」之動機。此改善計劃期望運用品質改善手法，提升創傷重症病人進行早期復健活動的達成率。改善策略包含進行團隊在職教育、建立創傷重症病人早期復健照會條件和作業流程、及發展合適的早期復健介入等措施。評值改善成效顯示，單位護理師與物理治療師對於創傷重症早期復健之認知率，均提升至近100%，創傷重症病人在轉出加護病房前，接受早期復健的達成率為100%，且下床活動比例為56.8%。顯示此品質改善活動，確能增加創傷重症加護內病人之功能活動程度。

關鍵字

早期復健；活動；創傷；加護病房

並列摘要

In recent years, studies have shown numerous benefits of implementing early mobilization for patients in the intensive care unit (ICU). However, early mobilization intervention is not only difficult to implement in the ICU but there is inconsistent method applied for patients with major trauma. We aimed to enhance the achievement rate of early rehabilitation and mobility for major trauma patients in the ICU through taking a quality improvement approach. Our strategies included conducting multidisciplinary team meetings and training sessions, establishing consultation criteria and procedures for early rehabilitation, and developing feasible activities. After implementing the project, the accuracy rate of early mobilization recognition was almost 100% for the physical therapists and unit nurses in the trauma ICU. At the time of discharge from the ICU, the implementation rate for early rehabilitation intervention was 100% for major trauma patients, of whom 56.8% were able to reach early out-of-bed activities. The application of quality improvement project can help major trauma patients in the ICU improve their functional activity abilities.

並列關鍵字

early rehabilitation ； mobilization ； trauma ； intensive care unit

參考文獻

Zomorodi M, Topley D, McAnaw M. Developing a mobility protocol for early mobilization of patients in a surgical/trauma ICU. Crit Care Res Pract2012;2012:964547. doi: 10.1155/2012/964547

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Fuest K, Schaller SJ. Recent evidence on early mobilization in critical-Ill patients. Curr Opin Anaesthesiol 2018;31:144-50. doi: 10.1097/ACO.0000000000000568

Newman ANL, Gravesande J, Rotella S, et al. Physiotherapy in the neurotrauma intensive care unit: A scoping review. J Crit Care 2018;48:390-406. doi: 10.1016/j.jcrc.2018.09.037

Paton M, Lane R, Hodgson CL. Early mobilization in the intensive care unit to improve long-term recovery. Crit Care Clin 2018;34:557-71. doi: 10.1016/j.ccc.2018.06.005

國際替代計量

＂Let's Move It＂提升嚴重創傷病人早期復健達成率

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