運用跨團隊提昇急性後期病人自主物理復健之執行率

Improving the Execution Rate of Physical Rehabilitation Among Patients in a Post-acute Ward

急性後期照護是從急性醫療到長期照護的過渡時期，藉由以病人為中心的跨團隊 照護和復健，可改善日常生活能力。本單位於2014年2月3-11日調查病人自主物理復 健完全執行率僅有72%。分析原因有醫護團隊對復健運動認知不足且教育訓練缺乏實 作、沒有將復健進度納入交班內容且醫護團隊間缺乏溝通、病人／家屬容易忘記物理 復健的步驟、病人／家屬不了解物理復健之重要性。經討論及參閱文獻後，擬定改善 策略如辦理教育訓練、使用復健交班SOP交班、運用團隊交班平台、舉行個案討論會 議、使用復健運動衛教單張及影片、運用行為改變策略後，病人自主物理復健完全執 行率提升至92.5%，不僅達成目標也改善了團隊間的溝通。

Introduction: Post-acute care is the period of transition between acute care and longterm care. It has been demonstrated that activities of daily living (ADL) and mobility could be improved through interdisciplinary care and rehabilitation. However, the execution rate of physical rehabilitation (PR) among patients in our post-acute ward was only 72%. Aims: The aim of the project was to enhance the execution rate of PR among patients. Methods: A situation analysis was conducted to investigate the difficulties of performing PR among patients and the barrier of health professionals. Four major causes were identified as follows: (i) insufficient knowledge and the absence of practice of training programs among health professionals; (ii) poor communication between health professionals; (iii) difficulties in memorizing the rehabilitation procedure among patients/family; (iv) unawareness of the importance of PR among patients. We proposed approaches included: arranging experiential education in the training program for health professionals, using cloud-based collaboration platform for interdisciplinary shift, developing PR pamphlets and a DVD, and applying behavior modification strategies to patients.