提升新進護理人員交班完整率之專案

A Project to Promote Invoice Nurses' Completion of Shift Hand-Off Report

10.29494/LN.201506_16(2).0009

林心怡(Hsin-Yi Lin)；何岱爭(Tai-Cheng Ho)；胡素華(Su-Hua Hu)；蕭雅文(Ya-Wen Hsiao)；許孟茹(Meng-Ju Hsu)

交班 ； 新進護理人員 ； hand-over ； the novice nurse

領導護理

16卷2期（2015 / 06 / 01）

66 - 80

繁體中文

交班是護理人員每日執行的重要工作，而有效率的交班，得以讓接班者迅速掌握病人的病情。本專案目的旨在提升新進護理人員交班完整率。改善前發現新進護理人員無法統整病人照護重點導致未能有系統的交班。經實地觀察、現況分析發現新進護理人員本身臨床經驗不足、臨床與學理無法連結、不知道交班重點、不熟悉儀器操作、記不住常見診斷、未按照標準流程執行等問題。故運用文獻查證與決策矩陣分析，擬定解決辦法：建立交班規範與簡化流程、進行教育訓練、製作提醒標語與制定工作手冊、訂定監測作業等措施。專案實施後，新進護理人員交班完整率由72.5%提升至92.9%，有效提升病人安全和照護晶質。建議未來將交班應具備之內容、技巧及原則，安排於新進人員訓練。

Hand-off report is an important shift nursing task. Complete hand-off report enables incoming nurses to rapidly understand their patients' medical status. The aim of this project was to promote invoice nurses' completion of hand-off report. Before implementing this project, the novice nurses of the ward could not highlight key care points and failed a systemic hand-off report. Through on-scene observation and status analysis, the identified problems for invoice nurses to complete hand-off report included insufficient clinical experience, failure to connect clinical status with academic theories, inability of highlighting hand-off reports, unfamiliarity with the operation of medical instruments, failure to memorize common diagnoses, and inability to following standardized workflow. Through literature review and a decision matrix analysis, the designed solutions included establishing a hand-off report model with simplified workflow, implementing an educational training, making reminder postings and work handbooks, and setting up monitoring measures. With the implementation of the project, invoice nurses' completion of hand-off report increased from 72.5% to 92.9%. This project greatly improved overall patient safety and quality of nursing care. This project recommends the addition of the content, skills, and principles of hand-off reports into nurses' orientation program.

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