提升血腫科病房護理人員善終準備執行率

Promoting the Execution Rate of Hospice Preparation for Patients in Oncology Unit

本文主旨在提升血腫科病房護理人員善終準備執行率，專案期間自2014年12月1日至2015年10月31日。2014年血腫科護理人員善終準備執行率僅38.91％，現況分析發現原因為醫療團隊資訊及照護流程無一致性、缺乏照護指引可遵循、缺乏癌症末期溝通實作技巧及病人或家屬對安寧療護概念不清楚等，讓善終準備無法全面執行。專案小組擬定並施行改善對策包括：安寧共照會診流程再造及製作資訊化彩色圖卡、建置善終準備照護手冊、成立溝通技巧實作坊、定期舉辦「心聆俱樂」支持團體及「愛關懷、癌開懷」活動，使護理人員善終準備執行率提升至79.41％，達專案目的，其結果能供全院各癌症病房執行之參考。

This project aimed to increase the execution rate of hospice preparation for patients by nurses in oncology unit. The implementation period of this project was from December 1, 2014 to October 31, 2015. In 2014, the average rate of hospice preparation in oncology unit was 38.91%. As revealed through an analysis of the situation, the reasons for low execution rate included an inconsistent perspectives on caring process and information among health professionals, lack of practice guideline to be followed, inappropriate communication skills to communicate with patients at terminal stage , lack of comprehensive hospice cognition in patients and family members. The following solutions were formulated and implemented: establishing ahospice care consultation procedure, designing colored information cards, establishing hospice preparation guidelines based on hospice shared-care team, conducting communication skill workshops, and establishing support groups of “listen to my heart” and “loving and caring for cancer”. The execution rate of hospice preparation increased from 38.91% to 79.41%; thus, the outcome of this project was achieved. This project provided a successful experience to other nursing units.