導入醫療團隊資源管理（TRM）對提升團隊照護品質之初探－－南部某醫學中心燒傷加護病房為例

Using Team Resource Management (TRM) to Enhance Quality of Team Care - Example from a Burn Center in Southern Taiwan

目的：運用團隊資源管理（TeamResourcemanagement，TRM）策略於燒傷加護病房之教育訓練及溝通，並分析團隊之合作滿意度、非計畫性氣管內管自拔率及平均住院天數之影響。方法：透過規劃之TRM課程及團隊自定之交班項目＂PT-CENTERED-ICU＂，建立以病人為中心之溝通及照護依據。結果：於TRM活動介入，團隊平均滿意度為4.41分，護理師與書記及醫師之滿意度大於呼吸治療師，達顯著水準（F=0.41,p=.012；F=0.50,p=.033）。計劃介入前後，非計畫性氣管內管自拔率從0.27%降為0.22%，平均住院天數從9.4天降為6天。結論與討論：TRM實施策略及正向成果，促進了臨床醫療團隊合作溝通。建議未來將此活動擴展於各個加護病房運作並增加客觀資料之收集，以期提升醫療團隊照護之品質。

Purpose: The purpose of this study is to apply Team Resource Management (TRM) in medical education and training of team members in the burn center and to analyze its influence on the cooperative satisfaction of team members, the frequency of unplanned extubation and the average length of hospital stay. Methods: To establish a patient-centered communication and care consensus through a planned TRM training and a team-organizing shift protocol (PT-CENTERED-ICU). Results: The average satisfaction score after induction of TRM activities in this team was 4.41/5 points. The satisfaction score of nurse , secretary and physician more than respiratory therapists, reaching significant levels（F = 0.41, p = .012；F = 0.50, p = .033）. After induction of TRM, the rate of unplanned extubation decreased from 0.27% to 0.22% and the average length of hospital stay from 9.4 to 6 days. Conclusion and Discussion: The TRM implementation strategies and positive results, promote to the cooperation and the communication in clinical. Propagation of TRM into different ICU settings to collect more objective information may facilitate to improve the quality of care from the medical team