提升急診病人出院護理完整性

Increasing the Integrity of Discharge Planning for Emergency Patients

出院護理完整性關係病人連續性照護、就醫滿意度及醫療成本，統計2016年10月1日至10月31日急診病人因護理人員執行出院護理不完整導致異常事件高達77件，造成病人或家屬不滿，投書院長信箱，甚至需要耗費更多時間彌補相關錯誤，增加單位成本耗費，經現況分析原因為急診缺乏出院流程標準作業及出院護理衛教不確實，故引發專案小組改善動機。本專案旨在提升急診病人出院護理完整性達91%。擬定解決方法：1.修訂急診病人出院護理標準作業程序；2.設計自備藥簽收卡；3.製作口袋卡、標準作業流程影片及QR code衛教資訊；4.創新口訣「生字教會管家」確認出院護理作業完整性；5.舉辦實務性在職教育。經專案改善後，統計異常事件由77件下降至5件。急診病人出院護理完整性由55.6%提升至92.8%，盼此專案提供臨床護理人員及他院急診出院護理標準作業執行之依循及參考。

The integrity of discharge planning is closely associated with continuity of care, patients’satisfaction to care, and medical cost. Statistics showed that, between October 1 and 31, 2016, up to 77 abnormal events were caused by incomplete discharge planning by the nursing staff, leading to dissatisfaction and complaints of patients and their family members. It took more time to rectify the mistakes and therefore increased the costs. After analysis, the reason was that the emergency department lacked standard discharge procedures as well as thorough nursing education. This motivated the task force to determine to improve. The project aimed to increase the integrity of discharge planning for emergency patients to 91%. The measures included revising of standard discharge planning operation procedures, designing a medicine receipt card, making pocket cards, creating videos for the SOP, providing education information that can be accessed with QR code, establishing mnemonic phrases for improving the integrity of discharge planning, and conducting practical in-service education. After the project, the number of abnormal events dropped from 77 to 5, and the integrity of discharge planning for emergency patients increased from 55.6% to 92.8%. We hope that such results can be the reference to other medical institutions and clinical nursing staff.