提升術後直送加護病房病人單位間交班完整性――以心臟外科為例

Improving the Standardized Protocols in Transferring and Handing-off Patients from OR to the Cardiac Intensive Care Unit

重大心臟手術病人嚴重度及未確定性高，交班的正確及完整，更是影響病人生命安全重要關鍵。本單位因無固定交班工具、交班內容不一致、交班單不適合術後病人、無統一標準規範、交班流程不同、忙碌易遺漏、未實行在職教育及品質監測等。經由設計單位間交班系統、制定交班規範、修正交班流程、創意電子交班口號、在職教育、新增電腦設備、設置電腦交班資訊操作手冊、持續品質監測後，交班完整率由59.6%分提升至94.2%，交班滿意度由3.6分提高至8.1分。專案後有效提升交班之正確性及完整性，單位間護理人員交班滿意度提高；促進單位間共同合作維護手術病人之安全及照護品質；未來將繼續平行推廣至各重症加護單位間交班之參考。

Timely and accurate transfer and information exchange are important to medical and nursing professionals. The aim of this study is to reduce missed information on handing off and transferring of patients from OR to the Cardiac Intensive Care Unit (CICU). Much literature have demonstrated that there is lack of standardized protocols in handing off, which is associated with missed information, inappropriate checklists, lack of SOP, different approaches to communicating contents of a hand-off, or lack of quality control. With the improvement on information and technology transfer, the addition of standardized protocols, corrections on the run-down of hand-offs, implementations of new slogans, one-onone continuing education and reward system, upgrades on computer systems, and continuous quality control , the effectiveness of transfer and hand-off (as demonstrated by the percentage of completed checklist items) has increased from 59.6% to 94.2%. Further, the satisfaction scores among nursing professional have rose from 3.6 to 8.1 points (out of 10). Technology transfer has played a major role in improving standardized protocols, and may be used to guide hand-off protocols in other wards and units.