某內科加護病房非計劃性氣管內管滑脫之改善方案

Project of Improving Unplanned Endotracheal Extubation in Medical Intensive Care Units

馬瑞菊(Jui-Chu Ma) ； 陳思佳(Si-Chia Chen) ； 李春香(Chuan-Hsiang Lee)

《醫護科技學刊》 7卷1期 (2005/01) Pp. 15-29

https://doi.org/10.6563/TJHS.2005.7(1).2

摘要

本院內科加護病房非計劃性氣管內管滑脫率與同級區域醫院比較居高，透過查檢及統計分析發現原因爲：缺乏與插管病患溝通之管道，致病患不知氣管內管的重要性、未建立氣管內管照護標準、以及未提供新進人員氣管內管照護在職教育。經專案設計制定了彩色圖文溝通本、原住民錄音帶以多種語言說明氣管內管之重要性、訂定氣管內管照護標準、並進行人員教育訓練等等。本室於91年9月至92年6月實施持續性改善計劃致非計劃性氣管內管滑脫率由原先之1.025%降至0.75%，目標達成率84.62%，改善率爲26.83%，雖然尚未達到專案設定之目標值，但改善成效顯著。未來仍持續進行統計分析並隨時修正改善措施，期望能達到最佳品質照護。

關鍵字

內科加護病房 ； 非計劃性拔管 ； 氣管內管

並列摘要

The rate of unplanned endotracheal extubation in the intensive care unit of our hospital that of regional hospitals of the same level. Lack of communication with the intubated patient leading to patients being unaware of the importance of the endo-tracheal tube; not establishing a standard protocol for caring for the endo-tracheal tube; and not offering on-job training to new staff working on the endo-tracheal tube. A special task force has designed a colorful and informative communication brochure, and tapes recorded in several aboriginal languages to help in communicating the importance of endo-tracheal tube, a standard protocol has been established for using the endo-tracheal tube, and staff have been trained in this area. Following the persistent application of this improvement program, the rate of unplanned endotracheal extubation was reduced from 1.025% to 0.75%. The target success rate is 84.62%. Meanwhile, the improvement rate is 26.83% Although the target has not yet been reached, an obvious improvement has been achieved. Hopefully, the program will be continued and any flaws optimize the quality of patient care.

並列關鍵字

Medical intensive care unit ； unplanned extubation ； endo-tracheal tube

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