改善創傷加護病房病人之護理交接班

Improve Nursing Handover for Patient in Trauma Intensive Care Unit

10.6320/FJM.201809_22(5).0009

陳盈如(Ying-Ru Chen)；劉士榳(Shih-Ting Liu)；周迺寬(Nai-Kuan Chou)；許立民(Li-Min Hsu)；詹靜媛(Chin-Yuan Tsan)

外傷 ； 情境模擬 ； 交接班 ； 病人安全 ； trauma ； scenario simulation ； handover ； patient safety

台灣醫學

22卷5期（2018 / 09 / 25）

530 - 542

繁體中文

外傷病人病情嚴重、複雜且需急迫處置，醫療團隊間交接班是照護過程重要一環；觀察加護病房與急診護理師應用現行交接班方式進行照護訊息傳遞，常會遺漏外傷照護重點。交接班照護完整率低原因：未制定照護規範、未建立稽核制度、照護知識不足、初級評估正確率低、外傷護理課程規劃不完整及在職教育舉辦頻率低。本專案旨在提升交接班照護完整率，專案措施：制訂照護規範及稽核制度建立結構性交接班方式，舉辦情境模擬工作坊及設置線上學習課程；交接班照護完整率由62.9％提高至95.1％，專案成效顯著。建議：發展情境模擬教學提升臨床照護能力；建立結構性交接班方式，落實醫療團隊間有效溝通；錄製情境模擬線上教材，增進自我學習成效。

Handover is an important part of trauma nursing care due to the urgent, serious, and complicated nature of the patient condition. However, using the current handover method, key points of trauma care are often omitted during the process. Reasons of low nursing care completion rate include: lack of nursing specifications, absence of audit systems, inadequacy of nursing knowledge, inaccuracy of primary assessment, incomprehensiveness of trauma nursing curriculum planning, and low frequency of on-the-job education. This project aimed to improve handover integrity rate through formulating care specifications and audit systems, establishing structured handover methods, holding scenario simulation workshops, and setting up online courses. The integrity rate of nursing handover increased from 62.9% to 95.1%, achieving remarkable results. Recommendations: Develop scenario simulation teaching workshops to improve clinical nursing abilities, establish structured handover methods to facilitate effective communication among medical teams, and produce scenario simulation online teaching materials to improve self-learning results.