提升加護病房電子護理交班作業完整性

Effectiveness of A Computerized Handover System in An Intensive Care Unit

目的：加護病房電子護理交班系統上線幾個月，仍出現交班訊息遺漏情形，影響病人持續性照護，專案目的旨在提升加護病房護理人員電子交班作業完整性，使照護訊息不遺漏。方法：以問題解決法，分析原因包括傳統交班與電子交班順序不同、不熟悉電子交班操作介面內容、等待電腦交班畫面時間過久。決策矩陣分析採取五個措施（一）訂定加護病房電子護理交班作業標準規範；（二）安排教育訓練及示教；（三）訂定查核計畫；（四）修訂新調入及PGYN學習護照內容（五）提案護理資訊組改善。結果：對策實施後，加護病房電子護理交班完整率由41％提升至99.4％，平均交班時間由15.5分鐘縮短至8分鐘。結論：訂定電子護理交班作業標準規範、教育訓練及稽核護理人員交班情形，可以有效提升護理電子交班完整率並縮短交班時間。

Purposes: Structured computerized handover systems have been established in many intensive care units; however, the integrity rate of the handover process is reported to be only 41%. The effect of five strategies on the handover integrity rate in an intensive care unit was evaluated. Methods: Five interventions were recommended based on decision matrix analysis, as follows: (1) establish standards of operations with a computerized handover system; (2) create in-service education programs for nursing staff; (3) establish audit mechanisms; (4) amend the content of transferred and PGYN Learning Passport; and (5) develop Quick Chart for Windows PCs. Results: The handover integrity rate increased from 41% to 99.4% by using the computerized handover system. The handover time spent per patient decreased from 15.5 to 8 min. Conclusions: Interventions can increase the integrity of information transfer between team members.