提升胃腸肝膽科病房急救作業完整性

Improving the Integrity of First Aid Procedures in Gastroenterology Wards

急救過程需要醫護團隊合作，如過程執行不完整，病人死亡率將提升。本單位病人常因病程惡化急 速而須立刻施予急救處置，完整的急救處置能減低死亡機會及提高生存後的生活品質，經現況分析實際 觀察護理人員執行急救過程完整率僅72.0%；急救認知程度僅75.2%，主因為單位內缺乏急救作業標準與 教育訓練及領導者工作分配不明確，且也缺乏急救成員工作職責。故制定急救作業標準及明訂各負責人 員職責、製作急救提醒隨身卡及急救車內容物放置圖卡、修訂在職教育訓練計畫內容，並舉辦擬真訓練。 專案改善後，急救作業完整性平均為98.9%，較改善前提升 26.9%，急救認知為 92.8%，較改善前提升17.6%。本專案結果可提升護理人員於急救時完整性及熟悉度，並強化團隊合作，提升照護品質，達到本專案目的，具推展價值。

The first aid procedures require the cooperation and integrity of the medical teams. If the implementation process is incomplete, the patient mortality rate will increase. According to previous investigations, the patients in the Gastroenterology Wards often need to be treated immediately because of the rapid progress of the disease. The completion rate of the first aid procedures for nursing staffs was only 72.0%. The main reasons for lower rate of completion rate were due to the lack of operation standards and education trainings, and lower personnel awareness of first aid (only 75.2%). Therefore, in this project, we formulated the operation standards for first aid procedures, and determine the responsibilities of responsible personnel. Besides, we produced the portable first aid reminder cards and the urgent content placement charts of emergency trolleys, in order to help medical personnel to perform first aid procedures smoothly. Moreover, we revised on-the-job education training programs and conducted medical simulation trainings to enhance the professionality of staffs. After implementing the project, the average completion rate for the integrity of first aid procedures increased to 98.9%, which was 26.9% higher than that before the improvement. The first aid awareness increased to 92.8%, which was 17.6% higher than that before the improvement. The results showed that this project can increase the integrity and familiarity of nursing staffs in first aid procedures, and strengthen the power of teamwork to improve the care quality. Our project achieved the study aims and can promote clinical practices due to significant improvement.