提升內科加護病房連續性靜靜脈血液透析過濾術照護完整率

Improving the Care Integrity Rate of Continuous Veno-Venous Hemodiafiltration in Medical Intensive Care Units

本專案旨在提升加護病房護理師執行連續性靜靜脈血液透析過濾術的護理照護完整率。在分析低完整率原因時，發現主要問題包括教育訓練不足、缺乏學習資源、無實作練習機會、紀錄表單無適用欄位，以及廢液量大且在病室內排放不易。透過模擬教具實作訓練與系列課程、製作簡易操作小卡與彙整數位參考資源、增修參數紀錄表單及改良廢液排放流程等策略的實施，我們將連續性靜靜脈血液透析過濾術的護理照護完整率由61.7%提升至98.8%。這不僅有助於維持適當過濾係數，延長過濾器壽命，也減少治療中斷的次數。我們計劃將這些成功的策略推廣至其他加護單位，以提升整體重症照護品質。

The project aims at improving the integrity rate of continuous veno-venous hemodiafiltration care performed by nurses in the intensive care unit. The reasons for previous low rate after analysis included insufficient education and training, lack of learning resources, no opportunities for practical exercises, no applicable spaces in the record form, and hard to discharge large amounts of waste dialysate in the ward. Through a series of courses for practical training with simulation teaching aids, aids of simple operation cards, a collection of digital reference resources, a revised parameter record form and the improvement of waste fluid discharge processes, the continuous veno-venous hemodiafiltration care integrity rate had increased from 61.7% to 98.8%. Also by maintaining an appropriate filtration coefficient and thus prolonging the filter life, the number of treatment interruptions was reduced. This strategy is expected to be extended to other intensive care units to improve the quality of critical care.