提升加護護理人員術後病人立即性照護認知及技能之專案

A Project to Enhance ICU Nurses’ Knowledge and Skills of Providing Immediate Postoperative Care

術後立即性照護關鍵為重建病人生理狀態、減輕術後疼痛和預防合併症，術後立即性照護正確性與病人安全息息相關。臨床上發現人員在執行照護上方式不一，影響照護品質及病人安全，因此激發專案改善動機，現況分析發現加護護理人員對術後立即性照護認知及技能正確性低。分析原因：(1)肝臟外科術後立即性照護作業標準不完整；(2)缺乏術後立即性照護教育訓練；(3)缺乏專科品質監控作業。經分析討論後之改善措施為：(1)制定術後立即性照護標準作業；(2)舉辦在職教育訓練；(3)製作術後立即性照護學習光碟；(4)設立術後立即性護理品質監測機制。透過專案實施後，結果顯示：術後病人立即性照護認知由78.3%提升達95.9%，照護技能由70.4%提升達95.5%，顯示專案介入措施成效顯著。

The key to immediate postoperative care are reconstructing physiological states of patients, reducing postoperative pain, and preventing complications. Accuracy of immediate postoperative care is closely associated with the safety of patients. The motivation of this project arises from concerns about the condition that nursing staff were found to have different ways of practicing care that could impact care quality and patient safety. According to analysis of the current status, ICU nurses’ knowledge and skills of providing immediate postoperative care is insufficient. Possible causes included incomplete standard protocols, lack of training of immediate postoperative care, and inadequate quality of nursing monitoring. The improvement measures included (1) Providing standard protocols for immediate postoperative care, (2) Providing in-service training sections for ICU nursing staff, (3) Creating an educational CD-ROM for learning immediate postoperative care, and (4) Establishing a quality monitoring mechanism. After implementing the project, the knowledge improved from 78.3% to 95.9%. The skill level increased from 70.4% to 95.5%. The results demonstrated the effectiveness of the intervention.