提升外科加護病房葉克膜照護完整率

Increasing the Completion Rate of ECMO Nursing Care in the Surgical Intensive Care Unit

10.6540/NTJN.202303_25(1).0006

許華娟(Hua-Chuan, Hsu)；顏玉雯(Yu-Wen Yen)；蔡雅雯(Ya-Wen Tsai)；盧幸茹(Hsing-Ju Lu)；朱翠萍(Tsui-Ping Chu)

外科加護病房 ； 葉克膜 ； 照護完整率 ； surgical intensive care unit ； ECMO ； caring integrity

新臺北護理期刊

25卷1期（2023 / 03 / 01）

58 - 70

繁體中文;英文

葉克膜照護流程與認知是提升照護完整性重要的一環。本專案旨在提升外科加護病房葉克膜照護完整率。現況調查發現護理人員照護葉克膜認知不足且照護流程標準無一致性、缺乏臨床指引及無實際照護訓練，影響葉克膜照護完整率僅44.6%。經專案措施介入：1.翻轉教學-葉克膜百分百訓練課程2.葉克膜快譯通輔助工具3.管路照護標準圖卡4.葉克膜移動創意口訣。專案實施後，葉克膜照護完整率提升至99.3%，達專案目的。同時護理人員照護認知54.9%提升至97.9%。建議運用可信賴專業活動（Entrustable Professional Activities，EPAs）認證制度及混成教學模式，發展於特殊疾病照護，共同提升病人照護品質及打造安全環境。

It is important to develop caring integrity by standardizing the procedures of Extracorporeal Membrane Oxygenation (ECMO) care. Therefore, this project aims to improve the caring integrity of ECMO in surgical intensive care unit (SICU). We have found in investigations that nurses in SICU are lack of recognition to ECMO, and there is no concordance in procedures regarding care of ECMO. There are problems of lack of clinical guidelines and insufficient care training programs. It leads to an integrity of ECMO care of only 44.6%. The project is then launched with the flip teaching-ECMO training and the investment of guideline booklets. After the project, the nurses in SICU could improve the integrity of ECMO care to 99.3%. In addition, the accuracy of recognition of care of ECMO elevates from 54.9% to 97.9% among nurses in SICU. For further studies and improvement in care of patients with ECMO in SICU, the application of Entrustable Professional Activities (EPAs) and a hybrid teaching model for development of care in special diseases are suggested. Therefore, we could improve the quality of patient care and establish a better environment for patient safety for ECMO care.

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