提升加護病房護理人員執行心肺容積監視器照護正確性之專案

Improving the Proficiency of Intensive Care Unit Nursing Personnel at Operating the Pulse-Induced Contour Cardiac Output

心肺容積監視器可密切監測病人血流動力狀態及評估心肺功能，為加護病房重要監視儀器，若操作不慎導致測量參數錯誤，影響病人安全及延遲醫療處置。本組調查發現護理人員執行心肺容積監視器照護正確性僅63.1％，原因有：心肺容積監視器照護認知低61.4％、無操作手冊、缺乏參數判讀工具、無定期教育訓練、監視器螢幕參數多。專案目的為提升加護病房護理人員執行心肺容積監視器照護正確性，經由製作操作手冊、參數判讀卡、QRcode、舉辦教育訓練及制定新版監視器螢幕，人員執行心肺容積監視器照護正確性由63.1％提升至98.3％，顯示成效良好，本專案運用多元改善措施，有效提升照護品質，使病人享有安全且優質的醫療照護。

The pulse-induced contour cardiac output (PiCCO) system enables the close monitoring of patients' hemodynamic condition and the evaluation of their cardiovascular function. The device is essential in the intensive care unit (ICU), and inaccurate readings caused by user error can endanger patients and delay the administration of necessary medical interventions. This study revealed that only 63.1% of nursing personnel were able to properly operate the PiCCO device. Reasons for this low rate included little awareness of how to operate the PiCCO system (61.4%), lack of a user manual, insufficient reference materials or tools for interpreting readings, lack of a routine training and equipment familiarization program, and the simultaneous display of too many readings on the screen. To improve the proficiency of ICU nursing personnel at operating the PiCCO device, this study implemented the following measures: the creation of user manuals, reference cards, and QR codes| the introduction of a routine training and PiCCO familiarization program| and the rearrangement of the screen interface. These measures yielded favorable results and increased the accurate PiCCO operation rate of nursing personnel from 63.1% to 98.3%. Therefore, this study concludes that improving nursing personnel proficiency at operating PiCCO effectively improved patient care quality, ensuring a safe and reliable medical environment.