精神科急性病房入院護理改善專案

全面的入院護理，有助於精神病患熟悉病房環境及規則，從而減少焦慮和暴力行為。目前入院護理流程繁瑣，家屬經常忘記攜帶必需物品或不符合安全規定，需重新購買而造成諸多抱怨，也增加醫療人員作業負荷，引發本專案動機。現況分析發現該病房入院護理完整率僅71.5%，乃因缺乏專科入院護理教育訓練、無合適輔助工具及執行方法無一致性（無依循標準）。針對上述問題，專案目標將精神科急性病房入院護理完整率提高到95%；病人對入院護理服務滿意度達到4.0分。本專案執行期間為2021年11月8日至2022年3月31日，依可行性、適當性、效益性和成本四方面進行決策矩陣分析，置入以下多元策略：（1）舉辦精神科入院護理訓練；（2）錄製精神科住院須知影片；（3）增訂「精神科住院小百科」；（4）設計精神科入院護理提示卡。實施後，入院護理完整率提高至97.2%，病患對入院護理的滿意度由3.0分提高至4.6分。本專案製作影音及輔助情境教材，可作為精神科急性病房入院護理的有效參酌。

關鍵字

精神科；急性病房；入院護理；多元策略

並列摘要

Comprehensive admission nursing that facilitate patient admission, assists psychiatric patients in becoming acquainted with the hospital environment and ward rules, thereby reducing their anxiety and violent behaviors. The current admission nursing process is cumbersome, and patients' family members often forget to bring necessary items, or they might bring items that do not comply with safety regulations and thus need to repurchase other acceptable items. This situation has led to numerous complaints and increased the workload for medical staff, prompting the initiation of this project. Analyzing the current situation of the case hospital revealed that the completion rate of admission nursing was only 71.5%. This unsatisfactory figure was mainly due to a lack of specialized admission nursing education and training, the absence of suitable auxiliary tools, and a lack of consistency in execution methods (i.e., the absence of standardized procedures). Given the aforesaid problems, this project aimed to increase the completion rate of admission nursing in the psychiatric acute ward to 95% and achieve an admission nursing service satisfaction score of 4. The project spanned from November 8, 2021, to March 31, 2022, and decision matrix analysis was performed on four aspects, namely feasibility, appropriateness, effectiveness, and costs, to identify the most suitable methods. The diversified strategies were: (1) conducting psychiatric admission nursing training; (2) recording videos on psychiatric hospitalization instructions; (3) creating a "psychiatric hospitalization encyclopedia;" and (4) designing psychiatric admission nursing cue cards. After intervention, the completion rate of admission nursing increased to 97.2%, and the score of patient satisfaction with hospitalization improved from 3.0 to 4.6. The videos and auxiliary scenario teaching materials created in this project may provide effective references for managing admission nursing for psychiatric acute wards.