運用兩階段圖像學習提升護理人員急救管理認知正確率

Using 2-Phase Image Learning to Improve First-aid Management Cognition of Nurses

黃婉菁(Wan-Ching Huang) ； 劉姿伻(Tzu-Ping Liu) ； 李宛珍(Wan-Chen Lee) ； 李佳倫(Chia-Lun Lee)

《高雄護理雜誌》 37卷2期 (2020/08) Pp. 33-44

https://doi.org/10.6692/KJN.202008_37(2).0004

摘要

背景：「提昇用藥安全」是國際病人安全目標，單位護理師因不熟悉急救車藥物發生誤拿局部麻醉藥物注射事件，引發改善動機。問題：專案小組利用訪談、觀察及問卷收集資料，以系統圖確立問題，發現護理人員對藥物項目及位置不熟悉、對用物位置及使用後處理不熟悉、常規急救演練不包含藥物作用。目的：急救藥物（藥物作用及位置）認知正確率達90%，急救用物（物品分層位置及使用後處理）認知正確率目標100%。方法：小組運用圖像學習自製急救藥物外觀與作用對應卡、藥物位置拼圖、急救車模型等介入改善。然成效不彰，故啟動第二階段改善措施，將上述用物結合遊戲、發展藥物重點小卡、記憶口訣並配合教育課程後，專案可達目標。結果：護理人員藥物作用認知正確率由72.5%提高到95.0%、藥物位置配對圖正確率由16.3%增加為93.8%、用物位置正確率由15.0%提升至95.0%，物品使用後處理正確率皆為100%。結論：此專案措施可供其他單位參考，以確保病人用藥安全，也建議發展經濟實惠的線上教育軟體。

關鍵字

圖像學習 ； 急救管理 ； 專案

並列摘要

Background: ＂Improve medication safety＂ is an international patient safety goal. This project aimed to improve the first-aid management cognition of nurses, which was motivated by a medication error of accidently administering a local anesthetic injection event due to the nurse being unfamiliar with the ambulance drugs. Problem: The improvement project conducted a comprehensive assessment including interviews, observations and questionnaires for data collection, with a system diagram being used to identify the main problems among nurses. Identified problems included unfamiliarity with the items and position of first-aid medications, and after-use management of first-aid supplies. In addition, routine first-aid practice for nurses did not include the practice of medication usage. Purpose: The first-aid cognition (medication effects and position) goal of nurses was aimed at achieving 90%, and the first-aid use (first-aid supplies position and after-use management) goal intended to reach a cognitive correct rate of 100%. Methods: The image learning including pair cards of first-aid medication items and effects, while a medication position puzzle and ambulance model were used to improve the first-aid management cognition in phase 1 practice. However, the improvement effect was restricted, so the phase 2 practice was conducted by integrating the phase 1 materials into a situational simulation game practice, developing the memory key cards for first-aid medications and a catchy slogan. Results: The project goals were reached. The project results showed the first-aid medication effect cognition of nurses increased from 72.5% to 95.0%, the cognition of medication position increased from 16.3% to 93.8%, the cognition of first-aid supplies position increased from 15.0% to 95.0%, and the after-use management of all supplies reached 100%. Conclusion: This improvement project is available for other units to ensure patient medication safety, and it encourages the development of online education.

並列關鍵字

image learning ； first-aid management ； improvement project

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