縮短外科加護病房術後呼吸器脫離時間

目的：術後麻醉未甦醒暫時藉由呼吸器支持提供病人之呼吸，甦醒後病情穩定即進入呼吸器脫離流程，如延遲呼吸器脫離導致併發症發生，增加醫療成本及醫療品質，因此藉由此次醫療品質改善活動期能有效縮短術後呼吸器脫離時間。方法：統計本院品管圈進行前三個月，外科術後呼吸器使用者，經由現場觀察及電子表單紀錄，進行要因解析後，擬定對策實施。結果：對策實施後，由改善前呼吸器脫離時間8.2小時縮短為5.5小時（目標值為6.7小時），進步率為33%；呼吸器脫離率由改善前91%提升至96.2%（目標值為95.8%），進步率為5.71%。結論：執行對策實施後有效縮短呼吸器脫離時間及提升呼吸器脫離率，減低呼吸治療臨床工作之負擔，有效率地縮短病人呼吸器脫離時間，提供最佳的呼吸照護醫療品質。

關鍵字

自動管路補償；呼吸器脫離時間；呼吸器脫離率

並列摘要

Objective: Postoperative patients are temporarily incapable of spontaneous breathing because they are still under anesthesia. Patients must be connected to a ventilator to provide breathing support. After their condition becomes stable, postoperative patients may have the ventilator weaned. Prolonged ventilator weaning may cause complications, furthermore, increased medical cost. Through this medical quality improvement program can effectively shorten the postoperative ventilator weaning time. Method: Postoperative surgery patients who received ventilator support during three month before this medical quality were observed. On-site observation was performed on the weaning process of patients considered ready to be weaned and their electronic medical records were reviewed to analyze the causes and to implement countermeasures accordingly. Results: After implementation, the weaning time was shortened from 8.2 hours to 5.5 hours (target value 6.7 hours) and progress was 33%. The weaning rate was increased from 91% to 96.2% (target value 95.8%) and progress was 5.71%. Conclusion: The introduction of automatic tube compensation as an assistive respiratory module as well as the implementation of relevant countermeasures can effectively shorten the postoperative ventilator weaning time and increase the postoperative ventilator weaning rate. The effective workload of respiratory therapist.

並列關鍵字

automatic tube compensation ； ventilator weaning time ； weaning rate

國際替代計量

縮短外科加護病房術後呼吸器脫離時間

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