運用創新思維提升某精神科急性病房治療環境滿意度之專案

建構良好的治療環境可以提升精神科病人安全和生理需求，更能紓解工作人員的身心壓力。本專案旨在提升病人與護理人員於精神科急性病房治療環境的滿意度，病人對住院治療環境之滿意度為73.4%，護理人員為63.1%。針對現況分析導因包括三方面—環境方面：環境布置單調無特色、醫院伙食菜色缺乏變化且選擇性少，影響病人對治療環境的期待；制度方面：團體活動缺乏多元化且時間有限制；人員方面：護理人員文書作業多且須兼顧非護理業務，缺乏緊急暴力處理能力，影響病人照護品質及治療性關係，進而對治療氛圍造成惡性循環。運用創新思維的介入改善方案包括：(1)名人畫作展示及結合健康講座主題、(2)伙食增加快樂餐、(3)環境佈置美化、(4)團體活動多元化、(5)護理工作簡化、(6)情境模擬建立緊急處置一致性等。專案執行後病人及護理人員對治療環境滿意度達85.3%以上，藉由護理的創新讓同仁與病人建立夥伴關係而達到雙贏局面。

關鍵字

創新思維；精神科急性病房；治療環境

並列摘要

The construction of a sound treatment environment can enhance the safety and psychological needs of psychiatric patients, in addition to reliving the mental and physical stress of personnel. This project aims to enhance the satisfaction of patients and nursing personnel regarding the acute psychiatric ward treatment environment. Patients’ satisfaction with the in-hospital treatment environment is 73.4, and nursing personnel’s satisfaction is 63.1%. The current situation analysis includes three aspects. First, Environmental Aspect: The environment layout is monotonous without special features, and hospital catering lacks variety and choices, which affected the patients’ expectations to the treatment environment. Second, System Aspect: Group activities lack diversification and have time constraints. Third, Personnel Aspect: The nursing personnel are overloaded with administrative work and have to take care of noncaregiving business, which lead to their insufficient emergency violence handling ability, and affects the therapeutic relationship in between patients and treatment’s care quality, resulting in a malignant treatment cycle. The intervention improvement plans through the use of innovative thinking include: (1) a combination of celebrity painting exhibitions and health seminar themes; (2) more delicious meals and a diversity of food; (3) environmental beautification; (4) group activities with diversification; (5) nursing care process’s simplification; (6) emergent situation simulation and establishment of handling SOP in consistency. After the project implementation, the patients and nursing personnel’s satisfaction with the treatment environment reached to 85.3%. Through nursing care innovation, the employees and patients could not only establish a partner’s relationship, but also create a win-win situation.