提升加護中心病人身體約束流程完整執行率

Promotion Patient’s Body Restraint Flow Integrity Execution Rate in the Intensive Care Unit

在強調醫療品質及病人安全的現今，醫療機構無不將行動限制（隔離、約束）視為一重要照護指標，新制評鑑也將約束納入評分重點項目中，可見其重要性。查核單位自2006年5月至2007年4月，病人身體約束人次比率為5.23%（次∕百人日）較同儕醫院0.87%高出4.36%，審視現行作業無病人身體約束作業規範及身體約束標準流程，且病人身體約束流程完整執行率偏低，僅達30%，故成立改善專案，透過制定身體約束作業指導書、發展病人約束護理紀錄單、約束醫囑章、製作身體約束教學檔案執行教育訓練及設立稽核制度，經改善措施實施後，病人身體約束流程完整執行率由30％提升至92%，期望藉由此專案提供臨床實施病人身體約束流程之完整性，以維護病人安全，進而提升醫療照護品質。

At present, in order to emphasize the quality of medical treatment and the patients' safety, almost every medical organizations view restraint as an important index of care and attention. In addition, new evaluation system has listed restraint as one of the essential evaluation items. From May, 2006 to April, 2007, the rate of implementing the patients restraints in the hospital is 5.23%, higher than that of the same-scale hospital which is only 0.87%, by 4.36%. The inspection department found that there are no standard protocols on the current patients' action confinement which result in low implementing rate of restraint, only 30%. Because of the mentioned reasons, the special improvement project was made and it includes the following procedures: making instruction books for implementation, designing the nursing record sheet of patient's body restraints, making the doctor's order seal of restraint, making the teaching portfolios of body restraints, implementing the educational training and setting up the assessment system. After carrying out this project, the rate was indeed elevated from 3000 to 92%. This project aims to provide the complete procedures of implementing patient's confinement for the clinical treatment and further improve the quality of medical treatment.