提升急診護理人員執行ISBAR交、接班之完整率

Performance Improvement Project: Using ISBAR for Hand-over in the Emergency Care Unit

林婉如(Wan-Ju Lin) ； 杜姝莼(Shu-Chun Tu) ； 陳乃菁(Nai-Ching Chen) ； 黃惠滿(Hui-Man Huang)

《高雄護理雜誌》 39卷1期 (2022/04) Pp. 30-41

https://doi.org/10.6692/KJN.202204_39(1).0003

摘要

交、接班及檢視病人是護理人員每日的常規例行工作。缺乏結構性交班易影響護理人員傳遞訊息的正確性及一致性，進而危害病人安全。本專案旨在提升急診護理人員執行ISBAR交、接班之完整性，改善前經實地觀察、現況分析發現急診護理人員欠缺ISBAR交班概念、缺乏輔助表單、未建立交接班稽核機制、交班過程被干擾中斷等問題。經運用文獻查證與決策矩陣分析，擬定執行改善方案：依ISBAR原則制訂交接班內容查核表、制訂交班指引單、制定交接班稽核制度、改變交接班模式、將ISBAR交班方式列入新進人員學習手冊內容、舉辦在職教育課程及情境模擬演練後，急診護理人員能落實ISBAR交接班模式；交、接班完整率由78.9%提升至96.7%，達專案改善目的。

關鍵字

ISBAR交接班 ； 急診護理人員 ； 護理交班一致性 ； 完整率

並列摘要

The nurse-to-nurse handover is routine in daily clinical nursing. Lack of structured handover can affect the consistency and correct of handover that might cause omissions and threaten patient safety. The purpose of this project is to insure and improve the consistency of nurse-to-nurse handover in the emergency care unit. An interview and structured questionnaire were used to collect the data of handover consistency and its problems. Before implementing the project, four problems were identified: Nurses lacking in ISBAR handover concept, lack of ISBAR handover sheets, lack of monitoring tools, and the handover process being repeatedly interrupted. After questionnaire was applied and matrix analysis and literature verification were performed, the following interventions were administrated: handover checklist with the ISBAR principles was implemented, handover use guidelines were established through the handover monitoring mechanism and the handover model was changed, with the ISBAR handover standard including a handbook, on-the-job handover education courses and situation simulation. After the implementation of this project, the handover integrity rate in nurses was elevated from 78.6% to 96.7% with the project successfully achieving its goal.

並列關鍵字

ISBAR handover ； emergency care nurses ； nursing shift handover consistency ； integrity rate

參考文獻

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