提升重症病人轉送過程完整性之改善專案

Completeness Improvement Project on Transfer of Critically Ill Patients

盧育汶(Yu-Wen Lu)；白筱雯(Hsiao-Wen Pai)；李彩緣(Chai-Yuan Lee)；屈靈怡(Ling-Yi Chiu)

重症病人 ； 轉送完整性 ； 改善專案 ； Critically ill patients ； Transfer Completeness ； Improvement project

若瑟醫護雜誌

9卷1期（2015 / 07 / 01）

62 - 72

繁體中文

重症病人轉送過程中，容易因病情不穩定發生嚴重的合併症，而事前完整評估及轉送設備完整，可提升病人轉送過程安全，降低轉送之風險。方法：本專案於2012年7月稽核加護單位重症病人轉送過程完整性僅84.7%。為了解重症病人轉送過程不完整的原因，專案小組成員針對34位護理人員進行開放式問卷調查，依政策、人員、環境三方面填寫認為導致病人轉送過程不完整原因並加以歸類，並修訂「病人轉送安全評估表」、安排在職教育訓練、制定查核機制、檢視並重新規劃轉送動線。結果：本專案實施後，重症病人轉送過程完整性由84.7%提升至99.3%，未達專案改善目標100%，但對提升病人轉送品質有幫助。結論：重症病人轉送過程完整性的提升與病人安全息息相闕，醫護人員對病人轉送時的照護上，應有史進一步的體認及共識，提升病人轉送照護品質，以達病人安全之目標。

Objective: In the transfer process of transfer critically ill patients are vulnerable to severe complications due to unstable illness state. Comprehensive pre-transferring assessment and appropriate transfer equipment may enhance patient safety and reduce risk to patients during transfer. Methods: The completeness rate of transferring critically ill patients was 84.7% as reported from an audit in intensive care units in July 2012. In order to identify the causes leading to incomplete transfer process, 34 nurses were interviewed to fill the open questionnaires. The potential factors leading to defective transfer were categorized into 3 types, including policy, personnel and environment. ＂Patient Transfer Safety Assessment Table＂ was revised. In subsequence, in-service training program was introduced and the inspection procedure was implemented. Furthermore, transfer plan was, reviewed and re-configured. Results: After the implementation of this project, the completeness rate of transfer critically ill patients was increased from 84.7% to 99.3%. Although the outcome failed to achieve the target of 100% completeness, the quality of transfer has been significantly improved. Conclusion: Improved completeness of transfer critically ill patients is highly associated with patient safety. Medical staffs need to awareness and consensus for the care of patients during transfer. Promoting the care quality during transferring patients can result in increased patient safety.

1. 劉寶玲,陳筱瑀,高淑美,楊青娥,謝嘉琪,戴辛翎(2011)。提昇急診病人轉送檢查交班之滿意度方案。醫務管理期刊，12，60-72。
   連結：
2. Jarden, RJ.,Quirke, S.(2010).Improving safety and documentation in intrahospital transport: development of an intrahospital transport tool for critically ill patients.Intensive Crit CareNurs,26,101-107.
3. Lahner, D.,Nikolic, A.,Marhofer, P.,Koinig, H.,Germann, P.,Weinstabl, C.(2007).Incidence of complications in intrahospital transport of critically ill patients: experience in an Austrian university hospital.Wien Klin Wochenschr,119,412-416.
4. Schartel, SA.,Yeh, EL.(2010).Transport of critically ill patients.Critical Care Study Guide,239-255.
5. Voigt, LP.,Pastores, SM.,Raoof, N.,Thaler, HT.,Halpern, NA.(2009).Review of a large clinical series: intrahospital transport of critically ill patients: outcomes, timing, and patterns.J Intensive Care Med,24,108-115.
6. 周幸生,熊道芬,陳玉枝(2008)。護理工作環境與病人安全。新台北物理期刊，10，1-9。
7. 林淑茹,黃春女,王桂英,馬瑞菊,黃瑞蘭(2011)。提升氧療重症病人轉送過程完整性專案。領導護理，12，83-98。
8. 財團法人醫院評鑑暨醫療品質策進會(2012)。財團法人醫院評鑑暨醫療品質策進會: 101-102年度醫院醫療品質及病人安全工作日標。2012年9月10日取自http://www.patientsafety.doh.gov.tw/big5/News/News_view.asp?id。http://www.patientsafety.doh.gov.tw/big5/News/News_view.asp?id=318&cid=2
9. 高櫻芬,高婷婷,蔡育真,歐麗娟,呂昊芬(2009)。運用失效模式與效應分析提升重症病人轉送安全。秀傳醫誌，9，101-109。
10. 莊麗玉,李建德(2009)。交班─護理人員的溝通。護理雜誌，56，93-98。
11. 陳麗紅,鄧佩如,廖玉茹(2009)。提升加護病房病人轉送安全性之改善專案。長庚護理，20，343-351。

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