提升新生兒加護病房護理人員冷卻帽照護作業流程之完整性

A Project to Improve the Integrity of Cold Cap Therapy in Nursing Staff of Neonatal Intensive Care Unit

陳淑芬(Shu-Fen Chen)；魏秀芳(Hsiu-Fang Wei)；謝秀芬(Hsiu-Fen Hsieh)；范惠珍(Hui-Chen Fan)；劉春卿(Chuen-Ching Liu)

新生兒 ； 低溫治療 ； 冷卻帽 ； QR code ； 標準作業流程 ； cold cap ； hypothermia therapy ； newborn QR code ； standard operating procedure

志為護理-慈濟護理雜誌

17卷5期（2018 / 10 / 01）

89 - 100

繁體中文

低溫療法可降低周產期窒息所造成新生兒死亡率。統計目前冷卻帽低溫療法人數雖少但重要性大且未來使用性可能會逐漸增加。因個案數少、護理人員照護經驗不足導致作業流程完整性僅66.2%。為提升人員執行冷卻帽照護完整性，於2013年04月10日－11月30日改善：1.建立作業標準化。2.制定檢視表減少裝置耗時。3.將其標準作業設置QR code以增進持續、便利及一致性教學。4.舉辦在職教育。5.訂定見習制度增加照護經驗。6.制定作業審核表及監測計劃。結果：藉由標準化實施縮短了備物及裝置時間，提升冷卻帽裝置作業之流程，冷卻帽照護作業流程完整性由66.2%提升為100%，顯示人員已提升照護能力與品質。

Therapeutic hypothermia can reduce infant mortality caused by perinatal asphyxia. According to the current statistics, the number of cases receiving hypothermia therapy using cold cap is low, but each case is significant, as the future application of the device is likely to increase. The integrity of the cold cap therapy was only 62% due to limited number of cases available and the nursing staff lacking experience. To ensure the process integrity of cold cap therapy in nursing staff, the following interventions were implemented from April 10^(th) to Nov. 30^(th), 2013: establishing standard operating procedure (SOP), develop a flow chart to reduce processing time, generate a QR code linked to the SOP to facilitate a continual, convenient, and consistent education, hold on-the-job training, set probationary system to increase nursing experience, and implement checklists and monitoring program. The implementation of SOP significantly reduced preparation and installation time, improved the process flow of cold cap installation, and increased the integrity of cold cap therapy from 66.2% to 100%, which is a clear indication of improved care ability and quality in our nursing staff.

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