某教學醫院兒科病房入院環境介紹改善案

Project Report on Admission Environment Introduction in a Teaching Hospital Pediatric Ward

環境介紹是迎接新病人入院護理中重要護理措施。目的在增加新病人對醫院環境的熟悉及適應。在北部某醫學中心，兒科病房因佔床率高達92%且平均住院天數4-5天，造成人員需頻繁的執行入院護理，其中環境介紹因內容眾多人員執行時常有遺漏，造成病童與家屬因對環境不熟悉及對病室規則不清楚而重複詢問甚而產生抱怨。故於90年2月20日至90年3月30日期間，利用實際觀察、訪談及問卷調查的方法，收集目前病童入院時，環境介紹護理人員執行的情形及家屬對環境介紹之滿意度與需求，結果得知（一）護理人員執行入院環境介紹時因無法記住繁多之內容且缺乏書面輔助工具，執行完整性只達59%。（二）病患及家屬對護理人員提供之環境介紹滿意度僅達78%。3.家屬對入院環境介紹需求之項目依序為：醫師查房時間、護士呼叫鈴與對講機使用方法及位置介紹、書記服務項目、護理人員自我介紹等五項。為了改善兒科病房護理人員執行病童入院環境介紹之完整性，進而提升家屬對環境介紹之滿意度。經由問卷及訪談結果瞭解護理人員執行之困難及家屬之需求，建構輔助工具（住院須知衛教單張、平面圖、病室內各項設備使用說明單）及設計環境介紹之動線，藉由宣導、試行與再修正後全面推行，其結果顯示：（一）入院環境介紹完整性達96%，較執行前提升37%。（二）病患與家屬對入院環境介紹的滿意度達90%，較執行前提升12%。由此可見，本專案在護理人員執行環境介紹之完整性與家屬滿意度方面確實有顯著的成效。Environment introduction is one of the most important procedures in admission nursing activity. The purpose of environment introduction is to facilitate and ease patients, familiarity with the environment. Due to the lack of environment introduction in the pediatric wards of our hospital, it became difficult to satisfy our patients and their families. This study is to investigate how to improve environment introduction for the patients and their families admitted to pediatric wards. During February 20, 2001 to March 30, 2001, through questionnaires and observation, we investigated the admission environment introduction of pediatric wards. The results revealed: Firstly, nurses were able to complete only 59% of the complicated environment introduction without the help of written documents. Secondly, the satisfaction rate of patients and their families was only 80%. Thirdly, for children and their accompanied families, the items of environment introduction in need were the time of ward rounds, the instruction and location of patient alarm system, the clerk’s services and nurse self-introduction. After trials and modifications, through the construction assistant tools (ward introduction flow chart, admission health education sheet, maps, and facilities instructions) and propagations, the nurses could promote the environment introduction completion rate to 96% (37% increment). Furthermore, the satisfaction rate increased to 90% (10% increment). There are significant improvements in both the completion rate and family’s satisfaction rate.