降低急診檢查病人交班不完整率

Reduce the Incomplete Handovers of Examinations for Patients in Emergency Room

吳云湘(Yun-Hsianh Wu)；劉國楨(Kuo-Chen Liu)；林丹嬪(Tan-Pin Lin)；黃麗華(Li-Hua Huang)

病人安全 ； 交班 ； 團隊資源管理 ； Patient Safety ； Handover ； Team Resource Management

若瑟醫護雜誌

12卷1期（2018 / 10 / 01）

70 - 86

繁體中文

交班是提升醫療照護人員間有效溝通的重要一環，使用可記錄的交班單，能強化醫療團隊間有效的溝通，提供完整及安全的照護，藉由此專案降低急診檢查病人交班不完整率。專案實施前發現急診檢查病人交班不完整率高達79.7%，分析歸納原因: 1.病人情況緊急，未及時填寫完整。2.教育訓練不足，不清楚要填寫。3.缺乏急診侵入性檢查病人轉送標準作業流程。4.缺乏稽核制度。運用團隊資源管理概念執行「團隊資源管理共同完成急診轉送交班單溝通模式」及制定「急診侵入性檢查病人轉送標準作業流程」、「急診常用侵入性治療辨識單」及建置「病人轉送安全評核表」進行稽核，專案實施後交班不完整率下降至16.7%達專案目的，不僅增加工作有效溝通之效能，進一步確保病人的安全。

Handover is an important step to promote effective communication between health care providers. Using recordable check list of handover can enhance effective communication, providing complete and safe care. It can reduce rate of incomplete handovers in Emergency room. Our team found rate of incomplete handovers in Emergency room was 79.7% in the period between 2014/5/1 to 2014/5/20. The reasons were ascribed as: 1. There was no time to finish the check list because of patients urgent condition; 2. The education was not enough for clarity of the check list; 3. Lack of SOP about invasive examination in the Emergency room; 4. Lack of auditing system. Exectuting [modle of completely transferred handover memo in Emergency room with Team Resource Management] by concept of Team Resource Management, formulating [SOP of transfer for in for invasive examination in the Emergency room],[check list of commonly invasive examination in the Emergency room],and [check list of transfer safty],incomplete rate was reduced up to 16.7%, and it achieved the initially assigned goal. It not only ensured patients safety, but also elevated guality of nursing management.

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