提昇某急診加護病房護理交班完整性方案

Promoting Complete and Thorough Nurse Change Shift Reporting at an Emergency Intensive Care Unit

急診加護病房病人流動率大，科別屬性多且疾病嚴重度高，護理人員在快速的病人潮中，常未能有充分的時間掌握病況，隨即又要將病人轉出，如何讓護理人員能快速且正確掌握病人之病情，完整的交班顯得格外重要。本單位曾因同仁交班遺漏而延遲病人檢查及治療，造成病人之治療延遲，進而影響整體醫療團隊照護品質與醫護間情誼，因此成立專案小組，經查核顯示護理交班完整性僅達63％。藉由建立交班規範、增設輔助交班單，稽核評值其完整性，推行結果，護理交班完整性由63％提昇至89％，是值得在臨床上繼續推展，希望此專案之推展能提供給其他單位參考。

Complete and thorough shift change reporting is the cornerstone of accurate and effi cient nursing care in all Emergency Intensive Care Units. The major reason for this requirement is the high frequency of transfers and the occurrence of a wide diversity of severely ill patients across many subspecialties. In this environment, nursing staff encounter great challenges in a situation where there is limited time available to respond to them. Due to mistakes in nursing shift change reporting, patients within our unit had experienced delays in examinations and therapeutic interventions. This had resulted in the quality of nursing care being somewhat compromised and led to confl icts within our medical care team. Therefore a specialized team was created to form a monitoring system. Initially, the rate of complete and accurate nursing shift change reporting was only 63% in our unit. By establishing a standard shift change reporting system work list, and by evaluating the completeness of the reporting, the success rate was raised to 89%, which was the goal of this project. Based on this improvement, this approach is worthy of promotion and it is hoped that this project will help other units to also improve their shift reporting.