運用精實管理改善外科加護病房交班耗時

The Application of Lean Management to Improve Nursing Handover at Surgical Intensive Care Unit

10.6320/FJM.202307_27(4).0016

胡雅潔(Ya- Jie Hu)；呂彥儀(Yen-Yi Lu)；徐雯娟(Wen-Chuan Hsu)

精實管理 ； 加護病房 ； 交班耗時 ； lean management ； intensive care unit ； in nursing handover

台灣醫學

27卷4期（2023 / 07 / 25）

520 - 529

繁體中文;英文

人員在時效內掌握病人完整交班訊息，是確保照護品質及病人安全的重要工作。本專案旨在改善外科加護病房護理人員交班耗時，為有效找出導因，並解決問題，運用精實管理的價值流程圖分析，發現造成交接流程不順的原因為動作浪費、等待浪費、不良浪費及生產過剩浪費。依循精實管理原則，在集思廣益及決策輔助下，訂立方案包括建構交班系統化架構、規劃人員交班模式、制定中斷交班處理原則及教育訓練。有效將交班耗時由22分鐘縮短至9分鐘，改善達59.1%；交班內容完整性則由63.1%，提升至94.7%。精實管理的應用有助於發現問題，並減少浪費，進而提升效率及重症照護品質，有效改善交班作業，使護理工作發揮價值及效益。

It is an important task for personnel to grasp the patient's complete nursing shift within the time limit to ensure the quality of care and patient safety. Flow chart analysis revealed that the handover process was not a waste of behavior, poor delay, waste, and actual production waste. Following the principles of lean management, with the help of brainstorming, decision-making, and cost matrix, the determined plan includes a systematic structure of shifts, which effectively reduces the time required for shift education from 22 minutes to 9, and improves by 59.1%; shift content The number of personnel increased from 63.1 to 94.7%. Use tasks to find problems to reduce waste, continue to improve and medical quality effectively improve shift work, and make nursing work play its value and effect.