提升外科護理師對病人自殺之防範能力

Improvement of Ability of Surgical Nurses to Prevent Patients Suicide

本專案旨在提升護理師對病人自殺之防範能力，動機係本單位2016〜2018年發生2起病人自殺事件，經分析導因為：缺乏自殺防範照護經驗及在職教育；不熟悉自殺防範流程；缺乏使用評估工具技巧；缺乏危險物品置放指導規範及自殺高風險病人評估機制；未落實情緒壓力評估。透過建立自殺風險評估機制、製作自殺評估提醒卡及自殺防範海報、舉辦教育訓練等策略，護理師認知正確率由53.8%至92.9%；癌症病人壓力評估達成率由67.1%至99.4%；自殺評估執行率由15.4%至82.7%；病房危險物品置放指導率由0%至79.0%；信心由4.9分至9.2分；期間無自殺事件，成效良好。建議未來平行推廣，以促進病人安全及照護品質。

This program aims to improve the ability of nurses to prevent patients' suicide. This research was motivated by two patients committed suicide in a unit between 2016 and 2018. After cause analysis, the possible causes include lack of suicide prevention related care experience and on-the-job education, unfamiliarity with suicide prevention procedures, and lack of assessment tools/skills, lack of guidelines for the placement of dangerous goods, assessment mechanisms for high-risk of suicide patients as well as assessment of emotional stress. The method was to establish a suicide risk assessment mechanism, provide suicide assessment reminder cards and suicide prevention posters, and organize educational training. The correct rate of suicide awareness of nurses increased from 53.8% to 92.9%; the complete rate of stress assessment of cancer patients increased from 67.1% to 99.4%; the implementation rate of suicide assessment increased from 15.4% to 82.7%; the guidance rate for ward placement of dangerous goods increased from 0% to 79.0%; confidence increased from 4.9 points to 9.2 points; and during the study period, no suicide cases occurred, suggesting favorable program outcome. Therefore, we recommend disseminating these strategies to other units to improve patient safety and to enhance the quality of care.