提升急診護理師執行COVID-19風險評估流程完整率之改善專案

Project of Enhancing Completeness Rate of Emergency Nurses Performing the COVID-19 Risk Assessment Process

10.6142/VGHN.202306_40(2).0012

曾憶茹(Yi-Ru Zeng)；楊迎晨(Ying-Chen Yang)；曾怡菱(Yi-Ling Tseng)

新型冠狀病毒 ； 風險評估 ； 急診 ； novel coronavirus ； risk assessment ； emergency

榮總護理

40卷2期（2023 / 06 / 01）

210 - 219

繁體中文;英文

本單位於一週內發生二件因急診護理師未完整執行COVID-19風險評估導致疑似COVID-19病人進入急診室內，造成相關人員強制接受篩檢及自主健康管理之事件，故引發執行本專案之動機。本專案執行於2020年1月27日至2020年4月11日期間，目的為提升急診護理師執行COVID-19風險評估流程之完整率；經分析確立風險評估完整率低的原因為護理人員對COVID-19風險評估認知不足、未制定COVID-19風險評估標準流程、E化TOCC評估系統不符評估者所需、無外語版TOCC評估輔助工具及病人分流動線標示不清。改善策略包括制訂評估流程、舉辦教育訓練、增置電子疫情公告與評估流程簡圖、優化評估作業系統、建置外語版評估表、病人自我防護措施之宣導品與地面動線標示等方案。經專案執行後，急診護理師執行COVID-19風險評估流程之平均完整率由67.3%提升至93.6%，提升風險評估正確性，進而達到醫療處置的時效性，減少病人滯留急診與群聚感染。

In our unit, two patients suspected to have COVID-19 entered the emergency room within 1 week because of an incomplete COVID-19 risk assessment protocol, resulting in our medical personnel being forced to undergo screening and self-health management. This incident motivated us to launch this project. The purpose of this project is to improve the completeness rate of emergency nurses in implementing the COVID-19 risk assessment process. The project was implemented between January 27 and April 11, 2020. An analysis revealed that the main reasons for the low completion rate of the nursing staff were a lack of knowledge regarding COVID-19 risk assessments, a lack of a standardized protocol for COVID-19 risk assessments, the failure of our unit's electronic TOCC assessment system to meet our risk assessment needs, the lack of a foreign-language version of our TOCC assessment aids, and the unclear marking of patient flow lines. This project involved establishing an assessment procedure, providing training, introducing electronic pandemic updates, optimizing our assessment system, producing assessment guides in foreign languages, producing a simplified chart of our assessment procedure, providing brochures about patients' self-protection measures, and labelling signs on the ground to indicate where to go. After the implementation of the project, the average completion rate of emergency nurses in implementing the COVID-19 risk assessment process increased from 67.3% to 93.6%. This finding indicates an increase in the accuracy of risk assessments, which in turn ensured the timeliness of medical treatment, reduced length of stay in the emergency department, and prevented cluster infection.

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