運用多元策略提升急診病人術前準備作業完整率

Multiple Enhancement Strategies to Investigate the Completion Rate of Preoperative Care in the Emergency Department

房怡慧(Yi-Hui Fang)；郭泓慧(Hung-Hui Kuo)；張家瑜(Chia-Yu Chang)；曾彥菁(Yen-Ching Tseng)；盧美言(Mei-Yen Lu)；何岱爭(Tai-Cheng Ho)

急診 ； 術前準備 ； 完整 ； completion rate ； emergency department ； preoperative preparation

志為護理-慈濟護理雜誌

21卷1期（2022 / 02 / 01）

95 - 109

繁體中文

本專案主旨在運用多元策略提升急診病人術前準備作業完整率， 並依據衛福部109－110年度醫院醫療品質及病人安全工作目標：提高手術安全，調查結果本單位2018年11月份手術前準備作業完整率僅72.92%，且執行術前準備作業認知率僅81.90%。現況分析瞭解後，提出解決方法：（一）制訂標準與稽核辦法、（二）規範查核表使用標準、（三）舉辦遊戲式教學課程、（四）運用同意書填寫指南針、（五）製作術速包、（六）創作順口溜、（七）製作學習繪本。經措施執行後，人員執行術前準備作業完整性及認知率達100%，達專案目的且成效良好，計劃將對策平行推展至外科病房，以協助提升術前準備完整性，保障病人安全，為護理盡一份心力。

Multiple enhancement strategies have been used to investigate the completion rate of preoperative care in the emergency department. Preoperative patient care was investigated based on the Ministry of Health and Welfare's annual goals in improving medical quality and surgical patients' safety in 2020-2021.The study showed the completion rate of preoperative care was 72.92% in November 2018. The rate of nursing staff acknowledging the standard and accuracy of the preoperative preparation was 81.90%. The following strategies were used to improve the preoperative care: (1) to establish standards of preoperative preparation in emergency department, (2) to develop a preoperative consent checklist, (3) to improve learning by incorporating a game in teaching, (4) to use an example to guide the patients to complete the preoperative consent form, (5) to include the items of preoperative care in a ready package, (6) to develop catchy phrase to help in the preoperative preparation, (7) to use a cartoon to help the staff and the patients acknowledge the preparation of the preoperative care. The completion rate of the preoperative preparation and the rate of the nursing staff acknowledging the standard and accuracy of the preoperative preparation have reached 100%. In conclusion, the multiple enhancement strategies showed an effective measure to improve the preoperative care in the emergency department. Acknowledgment: Our effort has been acknowledged by the surgical ward and was adapted to the surgical patient care.

1. 林孟樺,方淑華,黃如鈴,張素雯,江如萍,蘇芬蘭,李淑娟(2019)。運用精實管理改善護理行動工作車設置及作業流程之專案。志為護理，18(5)，63-72。
   連結：
2. 林淑貞,廖彩屏,達惠芳,詹淑惠,李秋香(2015)。降低急診室和手術室交班缺失率之專案。領導護理，16(3)，55-68。
   連結：
3. 洪郁惠,陳慧,鄭順意(2015)。提升外科病房手術前準備完整率之改善專案。亞東學報，35，31-41。
   連結：
4. 陳怡燐,陳翊珺,吳怡蓁,陳育臨(2020)。提升射頻腫瘤燒灼術病人術前準備完整率。嘉基護理，20(1)，1-12。
   連結：
5. 楊舒閔,陳靖妙,張素勤,林瑞珠,陳淑華(2015)。手術室人員執行捐贈骨骼及韌帶作業之改善。長庚護理，26(4)，449-460。
   連結：
6. 謝金杏,張詠涵,吳淑美(2018)。小組遊戲教學策略於課程之運用—以醫學術語為例。護理雜誌，65(6)，111-116。
   連結：
7. 藍湘湄,蔡薰儀,程音(2018)。運用資訊系統提升無痛鏡檢病人準備作業之完整率。領導護理，68(4)，73-84。
   連結：
8. 羅詒貞,王琦,賀倫惠,陳玉潔,戴秋玉(2018)。縮短顏面骨折導航手術前準備時間之專案。長庚護理，29(3)，393-406。
   連結：
9. Aij, K.H.,Teunissen, M.(2017).Lean leadership attributes: A systematic review of the literature.Journal of Health Organization and Management,31(7-8),713-729.
10. Malley, A.-M.,Young, G. -J.(2016).A qualitative study of patient and provider experiences during preoperative care transitions.Journal of Clinical Nursing,26(13-14),2016-2024.
11. Wong, A. K. C.,Wong, F. K. Y.,Chan, L. K.,Chan, N.,Ganotice, F. A.,Ho, J.(2017).The effect of interprofessional team-based learning among nursing students: A quasi experimental study.Nurse Education Today,53,13-18.
12. 衛生福利部(無日期)．臺灣病人安全通報系統2019年TPR年報 https://www.patientsafety.mohw.gov.tw/Content/Downloads/list01.aspx?&SiteID=1&MenuID=621273303702500244&SSize=10&CatID=621304160331571433