加護病房身體約束之改善方案

A Project to Improve the Physical Restraint in an Intensive Care Unit

身體約束用來維護病人安全，若應用不當可能導致傷害及死亡。本單位身體約束護理正確性多季低於閥值（80%），因此成立專案小組，旨在提升身體約束護理之正確性。經由實施在職教育、修訂常規、訂定單張填寫說明及護理紀錄書寫規範、推廣改良式約束手套及專人定期稽核等方案後，病人家屬對約束用具之滿意度，由2.17分提升到3.44分，護理人員由1.89分提升到3.0分；護理人員對身體約束的知識，亦由60.5分提升為96.8分；身體約束護理正確性由67%提升為100%。本專案能有效改善病人家屬及護理人員對約束用具的滿意度、增進護理人員對身體約束的認知，提升身體約束護理正確性，促進重症病患照護品質。

Physical restraint is to ensure patient safety, but improper use may lead to injury and death. Nursing care of physical restraint parameter was under threshold (80%) in our unit at several quarterly, for this reason, we conducted action team, and the aim was improving the nursing care quality of physical restraint. We carry out a training course, revising the routine, establishing a booking sheet and nursing record from, popularizing the revise restrain gloves and double check by supervise. The results were that families' satisfaction with restrain tool increased from 2.17 points to 3.44 points, nurses' satisfaction with restrain tool from 1.89 points increased to 3.0 points; nurses' knowledge of physical restraint increased from 60.5 points to 96.8 points; nursing care of physical restraint complete rate increased from 67% to 100%. This project can improve the families' and nurses' satisfaction, enhance nurses' knowledge and improve the quality of nursing care in critical ill patients.