改善急診與加護病房交接班安全

Improve Emergency and Intensive Care Hand off Seqcure

急診室病人科別屬性複雜、疾病嚴重度高且異動頻繁。急診護理人員在急救處置，穩定患者病況後，需與加護病房進行交班，如何讓兩單位間護理人員快速且正確掌握病人之狀況，因此交班的正確性及完整性格外重要。本單位與加護病房交班後，加護病房護理人員常因交班遺漏打電話至急診詢問及抱怨，造成急診與加護病房雙方時間的浪費與工作量增加，導致雙方在溝通過程中衍生出許多不必要的爭執與誤會，影響單位士氣，故實施此專案。經查核顯示護理交班的完整性為71.3%，藉由建立「交班作業規範」、「急診與加護病房交班指引單」及「交接班稽核制度」，交班完整性由71.3%提升至95.4%。目前仍持續進行中，並將此專案推展至開刀房與加護病房之術後交班，以維護重症病人之交接安全。期望藉由此專案之執行，可深入發展提升交班內容完整性之策略，以提供護理人員實際依循之辦法，保障病人安全與提昇照護品質。

Divisions of emergency room patients the property complex, the severity of the disease is high, and change frequently. Emergency nursing in the emergency treatment, patients with stable condition later, need to shift with the intensive care unit, how to make both nurses quickly and accurately grasp the patient's condition, so the correctness and completeness of the shift is particularly important. Our unit and intensive care unit after the handover, the ICU nursing staff often shift missed call to emergency inquiries and complaints, resulting in emergency and intensive care units both waste of time and the increase in workload, leading both in the communication process to produce many unnecessary disputes and misunderstandings, affect unit morale, so implementing this project. Check shows the integrity of nursing shift to 71.3%, through the establishment of ＂shift operation＂ and ＂guidelines on emergency and intensive care shift＂ and ＂succession of audit system＂, shift integrity upgrade from 71.3%. Are still ongoing and will be extended to BTS modus operandi for this project to the operating room and intensive care shift after surgery to maintain transfer security of the critically ill patient. Expected project implementation, and promote in-depth development of shift of content integrity policy, measures to provide practical nursing staff to follow to ensure patient safety and enhance the quality of care.