提升外傷科護理人員重症評估照護處置完整率

Improving the Complete Rate of Trauma Nursing Staff's Critical Care Assessment and Management

10.6540/NTJN.202103_23(1).0008

沈欣慧(Hsin-Hui Shen)；郭貞嬋(Chen-Chan Kuo)；邱存梅(Tsun-Mei Chiu)；鄭喬尹(Chiao-Yin Cheng)；謝昱嫻(Yu-Hsien Hsieh)

重症評估 ； 團隊資源 ； 照護處置 ； critical care assessment ； team resource management ； care management

新臺北護理期刊

23卷1期（2021 / 03 / 01）

77 - 89

繁體中文

外傷科病人為特性多變性與高複雜性，護理人員應具備專業重症評估照護能力，即早介入評估處置，避免非預期性心跳停止事件發生。2017年非預期性心跳停止事件5件，死亡率高達80.0%；分析問題為護理人員對重症評估照護處置完整性僅達63.0％、重症評估照護認知正確率僅達71.8%；解決辦法為建立「外傷科臨床通報流程」、運用「外傷科重症評估照護多媒體教案」、舉辦「急救擬真情境演練競賽」，設計「重症評估工具-紅綠燈警示圖」與「小惡魔呼吸卡」提示牌；專案結果護理人員重症評估照護處置完整率提升至93.5%，重症評估照護認知正確率提升至94.1%，執行12個月可有效降低非預期性心跳停止事件至2件，建議臨床應增加簡易呼吸照護評估工具，提升專科護理照護品質。

The characteristics of traumatic patients are variable and highly complex. Therefore, nursing staff must have professional critical assessment and care ability and early intervention in assessment and treatment to avoid unintended cardiac arrest events. In 2017, there were 5 unanticipated cardiac arrest events with a mortality rate of 80%. The main problem was that the traumatology care nursing staff had only 63.0% complete treatment for critically assessed care, and the correct rate of care for nursing staff was only 71.8%. The solution was to establish a ＂Clinical Notification Process for Trauma＂, use the ＂Disciplinary Critical Care Assessment Multimedia Teaching Plan＂, and host the ＂First Aid Situational Exercise＂, and design ＂Severe Assessment Tool - Traffic Light Warning Map＂ and ＂Little Devil Breathing Card＂ prompt card. Results of the project in the critical assessment of the care in the nursing staff increased to 93.5%. The critical assessment of nursing awareness increased to 94.1%. The implementation of 12 months effectively reduced the number of unexpected cardiac arrest events to 2. It is recommended that a simple respiratory care assessment tool should be added to improve the quality of specialist care.

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