提升加護病房護理人員臨床生理監視系統警訊處理率之改善方案

Improvement Nurses Response Rate to Clinical Alarms in an Intensive Care Unit

本專案目的在提升加護病房護理人員處理臨床生理監視系統警訊，經實際臨床觀察護理人員對生理監視系統警訊處理狀況進行調查，結果發現臨床生理監視系統警訊發生次數高達3,972次，而人員警訊處理率僅有1,116次（29%），原因歸納為；人員對警訊處理缺乏警覺性、缺乏警訊設定認知、假警訊產生、缺乏警訊設定規範、缺乏有效監控機制及隔離空間。經專案小組擬定策略；人員在職教育、制定有效監控機制、警訊功能檢測、制定臨床生理監視系統作業安全指引及進行安全查核改善後，監視系統警訊發生次數降為1,159次，處理率提升至96.7%。本專案結果期提供提升病患安全及臨床照護品質參考。

Clinical alarms alert healthcare professionals to any change in a patient's condition. The authors devised a program to improve nurses response rates to clinical alarms in an intensive care unit. The frequency of alarms and nurses responses were measured by observation. Prior to implementing a new system, nurses were responding to only 29% of clinical alarms (1116/3972). The factors contributing to nurses low response included lack of attention to alarms, lack of knowledge about setting alarms and about alarmsetting regulations, inadequate mechanisms for effectively monitoring isolation spaces as well as the regular occurrence of false alarms. Team members thus planned strategies to improve responsiveness: creating an education program for nurses, testing alarm functions, establishing patient safety guidelines for using the clinical alarm system, and monitoring outcomes from these interventions. After implementing these strategies, the frequency of clinical alarms decreased to 1159 instances and nurses response rates increased to 97%. The study provides a reference for improving the quality of clinical care and patient safety. (Tzu Chi Nursing Journal, 2007; 6:6, 117-126.)