提升加護病房護理人員執行心肺容積監視器照護正確性之專案

Improving the Proficiency of Intensive Care Unit Nursing Personnel at Operating the Pulse-Induced Contour Cardiac Output

賴佩霞(Pei-Shia Lai)；蔡宛容(Wan-Jung Tsai)；李若嘉(Rou-Jia Li)；馮葶憶(Ting-Yi Feng)

加護病房 ； 心肺容積監視器 ； QR code ； intensive care unit ； pulse-induced contour cardiac output ； QR code

志為護理-慈濟護理雜誌

19卷4期（2020 / 08 / 01）

67 - 79

繁體中文

心肺容積監視器可密切監測病人血流動力狀態及評估心肺功能，為加護病房重要監視儀器，若操作不慎導致測量參數錯誤，影響病人安全及延遲醫療處置。本組調查發現護理人員執行心肺容積監視器照護正確性僅63.1%，原因有：心肺容積監視器照護認知低61.4%、無操作手冊、缺乏參數判讀工具、無定期教育訓練、監視器螢幕參數多。專案目的為提升加護病房護理人員執行心肺容積監視器照護正確性，經由製作操作手冊、參數判讀卡、QRcode、舉辦教育訓練及制定新版監視器螢幕，人員執行心肺容積監視器照護正確性由63.1%提升至98.3%，顯示成效良好，本專案運用多元改善措施，有效提升照護品質，使病人享有安全且優質的醫療照護。

The pulse-induced contour cardiac output (PiCCO) system enables the close monitoring of patients' hemodynamic condition and the evaluation of their cardiovascular function. The device is essential in the intensive care unit (ICU), and inaccurate readings caused by user error can endanger patients and delay the administration of necessary medical interventions. This study revealed that only 63.1% of nursing personnel were able to properly operate the PiCCO device. Reasons for this low rate included little awareness of how to operate the PiCCO system (61.4%), lack of a user manual, insufficient reference materials or tools for interpreting readings, lack of a routine training and equipment familiarization program, and the simultaneous display of too many readings on the screen. To improve the proficiency of ICU nursing personnel at operating the PiCCO device, this study implemented the following measures: the creation of user manuals, reference cards, and QR codes; the introduction of a routine training and PiCCO familiarization program; and the rearrangement of the screen interface. These measures yielded favorable results and increased the accurate PiCCO operation rate of nursing personnel from 63.1% to 98.3%. Therefore, this study concludes that improving nursing personnel proficiency at operating PiCCO effectively improved patient care quality, ensuring a safe and reliable medical environment.

1. 林珍瑋,王筱珮(2016)。重症單位血液動力學監測介紹。護理雜誌，63(1)，117-124。
   連結：
2. 蔡至誠,羅希哲(2014)。QR Code應用於高職數學之教學歷程。中等教育，65(2)，110-121。
   連結：
3. Litton, E.,Morgan, M.(2012).The PiCCO monitor: A review.Anaesth and Intensive Care,40(3),393-410.
4. Norris, B.,Currie, L.,Lecko, C.(2012).The importance of applying human factors to nursing practice.Nursing Standard,26(32),36-40.
5. Zhang, Z.,Xu, X.,Yao, M.,Chen, H.,Ni, H.,Fan, H.(2013).Use of the PiCCO system in critically ill patients with septic shock and acute respiratory distress syndrome: A study protocol for a randomized controlled.Trials,14(32)
6. 林淑惠,林俊祐,林蔚如,賴宗志,洪靖慈,陳彥旭,張曉雲(2014)。醫療照護相關血流感染之危險因子。感染控制雜誌，24(4)，188-194。
7. 林紹雯,李惠筠,林靜宜(2014)。運用團隊資源管理（TRM）建構醫護訊息傳遞之溝通模式專案。醫學與健康期刊，3(2)，83-94。
8. 姚淑琴,徐淨如,蕭雅君,鄭紅霞(2010)。提昇加護病房護理人員對心肺容積監視器（PiCCO）照護認知及操作能力之改善專案。長庚護理，21(1)，60-70。
9. 陳莉卿,鄭之勛(2014)。重視管路事件，維護病人安全。醫療品質雜誌，5(2)，1-4。
10. 陳雅惠,蔡素珍(2010)。心肺容積監視器於敗血性休克病人的臨床應用。長庚護理，21(4)，443-449。
11. 陳麗芳,張嘉蘋,邱淑貞,馬先芝,江欣怡(2015)。某醫學中心護理人員對全面品質管理認知及實施與教育訓練之成效探討。醫療品質，6(1)，28-46。
12. 黃詩雯,陳靖瑛,張美淑,陳香蘭,郭美玲,陳桂英(2012)。提升病房護理人員執行護理品質監控作業正確性專案。長庚護理，23(3)，340-351。
13. 蔡富卿,何清治,賴美玉,李愛誠,鐘淑英(2016)。TRM技巧交班提升護理人員病安態度。醫療品質雜誌，10(3)，80-89。

1. (2024)。運用多元策略提升血液動力學監測儀照護正確率。護理雜誌，71(1)，72-80。