推動登革熱整合照護模式之歷程

An Experience Promoting the Interdisciplinary Care Model for Dengue Fever

10.6224/JN.63.4.135

郭文福(Wen-Fu Kuo)；柯雅婷(Ya-Ting Ke)

登革熱 ； 整合照護 ； 跨團隊模式 ； dengue fever ； integrated care ； interdisciplinary care model

護理雜誌

63卷4期（2016 / 08 / 01）

135 - 139

繁體中文

急診室為發生重大疫情時，第一線面對衝擊的單位，因此在疫情好發季節時，常常需要面對就診量高所造成的壅塞與待床人數攀升的現況。2015年夏季時節，南臺灣由於爆發登革熱疫情，第一線醫護人員無不面臨莫大的照護壓力。故本院以登革熱病人為中心，各部門資源進行整合性照護，不僅獲得民眾的肯定，更凝聚醫護團隊向心力，共體時艱度過疫情潰堤時期。在每年不斷重複的疫情，或是發生重大事件時，或許可做為實際執行經驗之參考。

Emergency departments represent the first line in facing major healthcare events. During major epidemic outbreaks, patients crowding into the emergency departments increase the wait time for patients and overload the staffs that are on duty. The dengue fever outbreak in southern Taiwan during the summer 2015 presented a huge management challenge for physicians and nurses in local hospitals. We responded to this challenge by integrating resources from different hospital departments. This strategy successfully increased group cohesiveness among the medical team, ensuring that they could not only ultimately cope with the outbreak together but also effectively provide patient-centered care. This interdisciplinary care model may serve as a reference for medical professionals for the management of future epidemics and similar events.

1. 陳亮恭(2015)。高齡醫療服務的發展─由片斷走向整合。護理雜誌，62(5)，23-29。
   連結：
2. 黃惠美、周幸生、陳玉枝(2014)。乳癌無縫服務─以某醫學中心實證模式建構整合性乳癌病人照護為例。源遠護理，8(2)，5-11。
   連結：
3. 胡勝川（2015，5月18日）．如何因應急診壅塞．取自http://www.thrf.org.tw/initiative/628 [Hu, S. C. (May 18th, 2015). How to deal with overcrowding in the emergency room. Retrieved from http://www.thrf.org.tw/initiative/628]
4. 疾病管制局（2012，4月11日）．登革熱流行病學、防治政策及相關法規介紹． 取自http://www.cdc.gov.tw/downloadfile.aspx?fid=00A3CFA4265F1A4C [Centers for Disease Control. (April 11th, 2012). Introduction to dengue fever: Epidemiology, prevention, and control policies. Retrieved from http://www.cdc.gov.tw/downloadfile.aspx?fid=00A3CFA4265F1A4C]
5. 紀志賢、吳肖琪、石富元、張文瀚、顏瑞昇、蕭政廷⋯范渚鑫（2011年11月）．急診壅塞之成因探討與解決之道．海報發表於「2011台灣醫學週─台灣聯合醫學會學術演講會」暨「臺灣醫學會第104屆總會學術演講會」．臺北：臺大醫學院。[Chi, C. H., Wu, S. C., Shih, F. Y., Chang, W. H., Yen, Z. S., Hsiao, C. T., ... Fan, J. S. (2011, November). An investigation of the causes and solutions of over-crowding in the emergency room. Poster session presented at “2011 Taiwan Medical Week-Taiwan National Medical Association Academic Convention and 104th Conference of the Formosan Medical Association”, Taipei City, Taiwan, ROC.]。
6. 衛生福利部疾病管制署（2015）．南區台南市登革熱本土病例及境外移入病例統計表─依發病日．取自傳染病統計資料查詢系統http://nidss.cdc.gov.tw/ch/SingleDisease.aspx?dc=1&dt=4&disease=061&position=3 [Centers for Disease Control, Ministry of Health and Welfare. (2015). Table of local and imported cases of dengue fever in Tainan City (southern Taiwan), by date of pathogenesis. Retrieved from Taiwan National Infectious Disease Statistics Systemhttp://nidss.cdc.gov.tw/ch/SingleDisease.aspx?dc=1&dt=4&disease=061&position=3]
7. Carter, E. J.,Pouch, S. M.,Larson, E. L.(2014).The relationship between emergency department crowding and patient Outcomes: A systematic review.Journal of Nursing Scholarship,46(2),106-115.
8. Coventry, P.,Lovell, K.,Dickens, C.,Bower, P.,Chew-Graham, C.,McElvenny, D.,Gask, L.(2015).Integrated primary care for patients with mental and physical multimorbidity: Cluster randomized controlled trial of collaborative care for patients with depression comorbid with diabetes or cardiovascular disease.BMJ: British Medical Journal,350,h638.
9. Dajczman, E.,Robitaille, C.,Ernst, P.,Hirsch, A. M.,Wolkove, N.,Small, D.,Palayew, M.(2013).Integrated interdisciplinary care for patients with chronic obstructive pulmonary disease reduces emergency department visits and admissions: A quality assurance study.Canadian Respiratory Journal,20(5),351-356.
10. Dickinson, G.(1989).Emergency department overcrowding.CMAJ: Canadian Medical Association Journal,140(3),270-271.
11. George, F.,Evridiki, K.(2015).The effect of emergency department crowding on patient outcomes.Health Science Journal,9(1),1-6.
12. Kingsnorth, S.,Lacombe‐Duncan, A.,Keilty, K.,Bruce‐Barrett, C.,Cohen, E.(2015).Inter‐organizational partnership for children with medical complexity: The integrated complex care model.Child: Care, Health and Development,41(1),57-66.
13. Kodner, D.,Kyriacou, C. K.(2000).Fully integrated care for frail elderly: Two American models.International Journal of Integrated Care,1(1),1-8.
14. Kruis, A. L.,Boland, M. R. S.,Assendelft, W. J. J.,Gussekloo, J.,Tsiachristas, A.,Stijnen, T.,Chavannes, N. H.(2014).Effectiveness of integrated disease management for primary care chronic obstructive pulmonary disease patients: Results of cluster randomized trial.BMJ: British Medical Journal,349,g5392.
15. Pines, J. M.,Hilton, J. A.,Weber, E. J.,Alkemade, A. J.,Al Shabanah, H.,Anderson, P. D.,Schull, M. J.(2011).International perspectives on emergency department crowding.Academic Emergency Medicine,18(12),1358-1370.
16. 陳亮恭、彭莉甯(2013)。整合式健康照護的發展。醫療品質雜誌，7(2)，27-33。
17. 鄧雅蓮、鄭秀容(2015)。門診整合照護於多重慢性病人效益之統合分析與臨床應用。榮總護理，32(3)，295-303。