提升精神科急性病房護理師急救處置能力的改善專案

Improving the Emergency Management Competency of Nurses on an Acute Psychiatric Ward

10.6847/TJPMHN.202308_18(1).05

劉雅惠(Ya-Hui Liu)；柳美如(Mei Ju Liu)；賴怡君(Yi-Chun Lai)；葉倩菁(Chien-Ching Yeh)

急救處置能力 ； 情境模擬教學訓練 ； 團隊資源管理 ； 精神科急性病房護理師 ； emergency management competency ； situational simulation training ； teamwork ； resource management ； nurses ； acute psychiatric ward

精神衛生護理雜誌

18卷1期（2023 / 08 / 01）

34 - 43

繁體中文;英文

提升急救處置能力對極少急救和最先到達現場的護理師格外重要。2019年發生3件非預期急救，護理師第一時間啟動急救的判斷和對急救流程不熟，引發成立專案動機。現況分析發現急救用物定位錯亂混淆辨識，缺比對圖片輔助辨識，不熟急救用物操作，急救教育缺情境模擬教案與團隊合作訓練，急救演練缺角色職責分工等。解決辦法：製作急救用物圖片，修訂急救車查檢表，舉辦情境模擬急救教育訓練，製作急救教學影片。實施後急救處置正確率由52.19%提升至90.94%，急救流程熟悉度由56.25%提升至90.63%，急救用物正確辨識100%，達專案目標。專案的急救情境模擬與團隊資源管理教學可作為傳統教育或經驗極少單位急救訓練參考。

Although nurses are rarely the first responders in medical emergency situations, they are often the first health-care professionals to handle such situations; hence, their first-aid-handling skills must be improved. In 2019, three unexpected cases in which first aid was required revealed our nurses' suboptimal judgment and inexperience in providing first aid care; therefore, we implemented a project to improve the first-aid-handling skills of our nurses. Our investigation unveiled several problems, including the disorganization of first aid items, lack of clarity in identifying these items, and unavailability of comparison pictures to facilitate identification. Furthermore, the nurses lacked knowledge about the proper use of first aid items, received insufficient first-aid-related situational simulation and teamwork training, and had not been assigned roles and responsibilities for first aid drills. To address the aforementioned problems, the following solutions were proposed: generating pictures to facilitate the identification of first aid items, revising the checklist for emergency vehicles, organizing situational simulation training, ensuring proper division of first aid roles and responsibilities and effective management of team resources, and creating videos for first aid education. The implementation of the aforementioned measures improved the accuracy of first aid care (from 52.19% to 90.94%) and the nurses' familiarity with the first aid process (from 56.25% to 90.63%). Notably, 100% of first aid items were correctly identified by the nurses after the intervention. These findings indicate improvements in our nurses' first-aid-handling skills. A situational simulation-based approach to first aid education and team resource management should be adopted at clinical settings with traditional education or no first aid experience.

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