提升急診護理師執行重大外傷病人處置之完整率

重大外傷病人死亡高峰期通常發生於急診救治過程，若能迅速且完整的評估及處置，儘早確立診斷，方可降低死亡風險。本專案目的為提升急診護理師執行重大外傷處置完整率，以穩定重大外傷病人病情。經調查2016年3月1日至3月20日急診護理師執行重大外傷病人處置完整率僅60.8%，發現缺失原因有：重大外傷小組護理人力、重大外傷病人處置經驗、教育訓練不足及缺少固定式生理監視器。透過增加執勤人力、增設牆上固定式生理監視器、運用客觀結構式臨床測驗、張貼重大外傷標準流程圖、舉辦重大外傷處置教育課程，提升急診護理師執行重大外傷病人處置完整率至97%。本專案提供急診重大外傷病人照護之參考，期待病人獲得即時及完整照護，改善疾病預後。

關鍵字

重大外傷；急診處置

並列摘要

The majority of deaths in major trauma patients usually occur in the emergency department. Nurses should be able to quickly and completely assess the primary, then report to the relevant treatment, and enter the secondary assessment as soon as possible to establish a diagnosis, thereby reducing the risk of death. An investigation of nursing staff in our unit, from 1 March to 20 March 2016, found that the treatment completion rate of patients with major trauma was only 60.8%. To improve the quality of care for major trauma patients, the aim of this project is to improve the completion rate for major traumas to 93%. Analysis of the current situation found that there are four reasons for the poor performance: shortage of nursing staff in the major trauma group, lack of fixed physiological monitors, lack of experience in nurses carrying out treatment of patients with major trauma, and insufficient education and training on major trauma. The completion rate of emergency nursing staff for the treatment of major trauma was increased to 97% by increasing nursing staff for major trauma, adding wall-mounted physiological monitors, using objective structured clinical tests, putting up standard operating procedures for major trauma, and organizing educational courses on major trauma. The results and process of this project can provide a reference for the clinical care of patients with major trauma, enabling them to obtain immediate and complete care, thereby improving outcomes.

並列關鍵字

major trauma ； emergency management

參考文獻

張元玫、李秋霞(2014)‧急診室護理人力需求探討‧健康與築雜誌，1(4)，75-80。

陳美容、趙純真、董曉萍、張玲華(2007)‧外傷護理之重要概念‧源遠護理，1(3)，56-63。

江如萍(2009)‧因材施教－OSCE首次運用在新進護理人員訓練‧志為護理－慈濟護理雜誌，8(4)，64-65。

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Clements, A., & Curtis, K. (2012). What is the impact of nursing roles in hospital patient resuscitation? Australasian Emergency Nursing Journal, 15(2), 108-115.

國際替代計量

提升急診護理師執行重大外傷病人處置之完整率

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