手術室護理人員執行術前訪視服務之專案

Pre-operative Assessment of Nursing Staff in Operation Room

醫療環境強調以病人為中心理念下，新制醫院評鑑基準亦強調手術室護理人員應到病人單位提供適切護理指導，故專案主旨在推展手術室護理人員術前訪視服務，經現況調查未執行因素：無執行術前訪視作業相關政策、住院手術病人多無法一一進行、擔心病人問題無法回答、無術前訪視指導工具、缺乏術前訪視成效評價。經本方案透過以下解決辦法：（一）建置術前訪視病人作業流程模式：包括建立術前訪視之程序、制定各專科「術前訪視護理指導標準」（二）藉由手術法與資訊管理部結合，提供術前訪視相關資料（三）舉辦相關教育訓練（四）制定術前訪視服務滿意度調查表。經介入方案後，術前訪視執行率達68.9％，護理滿意度4.4分，透過持續不斷進行改善，訪視執行率達82.68％。協助病人在最好的狀況下面對即將進行的手術，同時也讓病人更肯定手術室護理人員之專業評價及護理照護品質。

The concept of patient-centered care is consistently highlighted in medical communities. Current hospital accreditation stresses the need of providing appropriate nursing guidance for the patient. The aim of this project is to promote the pre-operative nursing service in the operation room. According to our investigation, incomplete pre-operative service was caused by: 1. lack of regulation to implement pre-operative visit; 2. shortage of manpower to carry out pre-operative visit; 3. incompetence to response to the questions raised by patients; 4. lack of pre-operative guidance; and 5. lack of evaluation system for pre-operative visit. Our proposed measures included: 1. to establish the standard procedures of pre-operative visit for the patient, including establishment of pre-operative procedure and guidance for pre-operative visit; 2. to combine operation and information management system and provide preoperation information to the pre-operative candidates; 3. to provide necessary training courses; and 4. to conduct satisfaction survey for pre-operative service. Our results indicated that the execution rate 68.9%. Satisfaction was 4.4 out of 5 points. The execution rate reached 82.68% through persistent implementation. The pre-operative visit service helps the patient to cope with the coming operation and also increase patients’ satisfaction toward nursing services.