提升醫療團隊間病人攝入輸出量交班成效之專案

The Project to Improve the Intake &Output among Shift Handover of Medical Team

10.6540/NTJN.2017.1.006

徐愬美(Suh-Meei Hsu)；楊宜霖(Yi-Ling Yang)；葉惠慈(Hui-Tzu Yeh)；李文瑞(Wen-Ray Lee)；孫瑤光(Yao-Kuang Sun)

護理資訊 ； 攝入輸出量 ； 交班 ； nursing information ； intake & output ； shift handover

新臺北護理期刊

19卷1期（2017 / 03 / 01）

59 - 70

繁體中文

本專案目的為提升醫療團隊間病人攝入輸出量交班成效，現況調查得知醫療團隊間攝入輸出量交班成效低主因為現行交班方式護理人員接受醫療團隊間詢問攝入輸出量的比率高為46.2%，紀錄正確率低為75.9%，紀錄耗時白班為51秒、小夜及大夜班為49秒及66秒，因無法及時查閱病歷致醫療團隊間滿意度低（2.78-3.06分）。綜合以上缺失，透過建立可供醫療團隊隨時交班及查詢之資訊系統，以提升醫療團隊間攝入輸出量交班成效。經專案實施後護理人員接受醫療團隊間詢問攝入輸出量的比率下降為21.1%，攝入輸出量紀錄正確率提升為96.4%；紀錄平均時間，白班縮短為44秒，小夜及大夜班縮短為41秒及28秒；醫療團隊間滿意度，護理人員由改善前2.78提升為3.47分，醫療團隊由3.06提升為3.46分。希望透過改善後增加醫療團隊間攝入輸出量訊息交班之正確性及即時性，以維護病人安全並提升照護品質。

The project is to improve the intake & output among shift handover of medical team. The investigation showed the low effectiveness of the amount of intake &output because the ratio that the nurses were asked from team members is 46.2%. The correct ratio of recording is 75.9%. The recording time is 51 seconds for day shift, 49 seconds for night shift, and 66 seconds for graveyard shift. The medical team satisfaction is low (2.78-3.06). Through the establishment of an amount intake & output of nursing information system, it was hoped to enhance the shift handover between the team effectiveness. After the implementation, the ratio that nurses were asked from team members is 21.1%. The correct ratio of recording is 96.4%. The recording time is shortened to 44 seconds for day shift, 41 seconds for night shift, and 28 seconds for graveyard shift. The nurse satisfaction is upgraded from 2.78 to 3.47, and medical team satisfaction is from 3.06 to 3.46. It is hoped that we can improve the correctness and timeliness of shift handover among intake & output in order to protect patient safety and improve quality of care.

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