以醫療品質突破系列提昇院內心跳停止事件急救之照護品質

To Improve the Care Quality of In-Hospital Cardiac Arrest by Breakthrough Series

院內心跳停止（in-hospital cardiac arrest, IHCA）是一項重要的病人安全議題，也是一個在醫療機構當中常見而且具高風險性的問題，IHCA 的發生與否，是醫院維護住院病人生命安全重要的品質指標，也是各醫院面對急、重症病患重大挑戰之一，其急救照護品質執行之成效關係到能否立即拯救危急瀕死病患之生命，也關係到是否能夠將病患的生命延續至出院存活。藉由持續性之多重監測及定期檢討改善措施，並透過醫療品質突破系列（breakthrough series, BTS）參與醫院之間的相互學習，突破現狀，能夠有效提昇院內心跳停止事件急救照護品質，包括改善院內心跳停止事件心肺復甦（cardio-pulmonary resuscitation；CPR）事件發生率、院內CPR 發生人數與住院人數比、院內成人CPR 病患死亡率、院內成人CPR 病患出院存活率、執行去顫術時間的時效、IHCA 事件發生的監測等。

In hospital cardiac arrest (IHCA) is an important issue in patient safety. It is a common, yet less well recognized area of high risk procedure that occur in all medical institutions. It presents as a major challenge for hospitals that provide care for critically-ill patients. The quality of resuscitation may ultimately determine whether a patient survives or discharges from the hospital. Factors that affect the success of resuscitation are multi-factorial. Continuous monitoring of statistics and regular audits are essential. By applying quality improvement projects such as the break-through series (BTS) is also helpful. Details of such projects include detailed event monitoring, correctly defining the denominators, reporting and improving the incidence of resuscitation, the time interval between arrest and resuscitation, the timing of defibrillation, mortality, discharge (survival), as well as benchmarking.