提升裝置心臟節律器患者整體照護完整率

A Project to Increase the Comprehensive Care Among Patients with Permanent Pacemakers

本專案旨在提升裝置心臟節律器照護完整率，強化患者健康照護系統及品質，降低相關傷害風險。本院2012年裝置心臟節律器共53件，當中出現8件異常傷害事件導致患者需緊急就醫進而造成身心壓力。分析後發現問題包含：無整合性照護團隊機制、無心臟節律器照護指引、裝置心臟節律器整體性照護認知不足以及缺乏心臟節律器報到流程與緊急處置機制。改善方案：製定裝置心臟節律器患者整合照護流程及照護指引、舉辦在職教育課程、宣傳個管師職責與功能、製作多媒體衛教設施與照護事項提醒卡、建立心臟節律器特約門診報到流程與緊急處置機制。結果顯示，專案執行後裝置心臟節律器患者整體照護完整率由9.4%提升至96.9%，確實達成目標。

This aim of this project was to increase the comprehensive care of permanent pacemaker implantation, enhance patient health care system and quality, and reduce related risk of injury. Out of the 53 cases of pacemaker implantation our hospital had performed in 2012, 8 cases of adverse events occurred that led to the immediate hospitalization of the patient and induced physical and mental stress. After reviewing these events, the reasons were identified as followed: absence of integrated-care team, no self-care guidelines for pacemaker patient, insufficient knowledge on the comprehensive care of pacemaker implantation, and the lack of emergency pacemaker registration process and emergency response protocol. The following solutions were proposed and implemented to address the identified issues: developing integrated-care process and self-care guidelines for pacemaker patients, holding in-service education programs, propagate the duties and functions of case manager, establishing a multimedia health education facility and reminder cards, and develop a registration process for pacemaker clinic and emergency response protocol. After implementing these projects, the rate of comprehensive care increased from 9.4% to 96.9%, which successfully achieved the intended goals.