提升心臟內科加護病房執行血管內目標溫控治療操作正確率

Improving the Accuracy of Intravascular Temperature Management in the Cardiology Intensive Care Unit

10.6740/NTUHJN.202401_20(1).0014

李羽婷(Yu-Ting Li)；莊寶玉(Pao-Yu Chuang)

心臟內科加護病房 ； 血管內目標溫控 ； 目標溫控治療 ； Cardiology intensive care unit ； intravascular temperature management ； target temperature control

臺大護理雜誌

20卷1期（2024 / 01 / 01）

152 - 166

繁體中文;英文

背景：本專案旨在提升加護病房執行血管內目標溫控操作正確率，此機器為新治療設備，僅少數人曾獨立操作，評核操作正確率偏低，護理師在操作儀器時顯得焦慮，顯示護理師對此技術不熟練，恐影響治療成效。分析原因：在職教育訓練不足使護理師對新儀器目標溫控治療認知不足、尚未建立技術規範、案例少無實機練習機會、缺乏適用教材。目的：護理師執行血管內目標溫控操作正確率由74.3%提升至95.0%。解決方案：透過舉辦在職教育講授血管內目標溫控治療（intravascular temperature management, IVTM）原理、組成種子教師一對一回覆示教實機練習、制定標準作業流程暨查核表、製作數位教學影片、中文操作手冊與警報處理手冊。結果：以情境模擬進行評核操作正確率74.3%提升至96.5%，半年後再測100%維持專案成效。結論：新進護理師續採一對一教學指導，並將數位教學影片平行推展至其他加護病房。希冀藉此專案，善用輔助教材及教育訓練幫助重症護理師們熟悉操作流程，減少臨床實務缺失。

Background: This study aimed to improve the accuracy of intravascular target temperature control operations in the intensive care unit (ICU). This machine is a new treatment device and only a few staff members have operated it independently. However, the accuracy rate of this machine in clinical practice is low. This indicates that most nurses are unfamiliar with this technology, which may affect the effectiveness of its treatment. The main causes of the nurses insufficient awareness of the new instrument were: 1) insufficient in-service education and training; 2) unestablished technical specifications; 3) few cases and opportunities for practice; and 4) lack of suitable teaching materials. Purpose: To increase the accuracy rate of intravascular target temperature control from 74.3% to 95.0%. Resolution: In-service education was conducted to teach intravascular temperature management (IVTM) principles, established seed teachers to teach one-to-one machine operation, and formulated standard operating procedures and checklists. Digital teaching videos, the operator's manual, and alarm handling instructions in Mandarin were created. Results: The correct operation rate increased from 74.3% to 96.5% through situational simulation, and the project effect was maintained at 100% after half a year. Conclusions: The results showed that one-to-one teaching guidance was continuously adopted, and the digital teaching video was extended to other ICUs in parallel. Through the auxiliary teaching materials and educational training in this project, nurses became familiar with this procedure to decrease the inaccuracy of clinical practice.