提升加護病房敗血症病人輸液復甦照護之完整率

Improving the Complete Rate of Fluid Responsiveness Care in Patients with Sepsis in ICU

本專案旨在提升加護病房敗血症病人輸液復甦照護之完整率，專案動機因本單位敗血症病人佔37.4％，有些病人常輸液不足需追補輸液量，有些病人卻因輸液量過多而發生併發症，故提供重症病人最佳化輸液復甦相當重要。專案改善過程中藉由更新輸液復甦流程、發展評估工具、實施照護種子制度、製作水腫評估影片與教育訓練等方式。實行後敗血症病人輸液復甦照護之完整率由62.0％提升至98.4％，效果維持100％，達成專案目標。本專案之實行，陸續以演講方式分享並平行推展至其他加護病房，並期望能建立全院共用版的標準文件，方便全院線上查閱，共同為敗血症輸液復甦照護盡心力。 The main purpose of our project was to promote the completion rate of fluid resuscitation bundle in patients with sepsis in our ICU. The prevalence rate of sepsis in our ICU was 37.4%. However, the condition of fluid overload and de-resuscitation may occur, and it was associated with worse outcomes in same patients. Optimized management of fluid balance becomes a central component in critically ill patients. Therefore, our strategy was focus on updating the previous fluid resuscitation bundle, developing new assessment tool, training seed teachers for fluid resuscitation bundle, shooting a film for edema assessment, arranging in-service education etc. After putting into practice, the complete rate of fluid responsiveness care in patients with sepsis improved from 62.0% to 98.4%, and the maintenance rate of effect was 100%. We will share our experience to other intensive care unit in our hospital by taking place several speeches. Finally, we hope to establish a standard version of the document with online access for everyone to fight with sepsis together.