降低某醫學中心內科病房壓力性損傷發生率之改善方案

Reducing the incidence of hospital-acquired pressure injuries in an internal medicine ward

本專案旨在降低病房壓力性損傷發生率。統計單位2018年第一、二季壓力性損傷發生率為0.323％和0.355％，明顯高於本院目標值0.07％，且為單位異常事件發生率之第一名，為本單位迫切需改善的品管及照護指標。經由原因分析及檢討後，舉辦相關教育訓練、製作翻身擺位護理指導單及影片、提供翻身輔助工具及制訂審查機制等改善措施。專案執行後，2018年第三季、第四季及2019年第一季壓力性損傷發生率分別為0.24％、0.22％和0.14％，雖未達目標值，但發生率有逐漸下降，壓力性損傷照護亦有提升。台灣家庭結構改變及高齡化社會，外籍人士常擔任主要照護者角色，藉由多語言之衛教單及影片（中文、印尼文、越文）、持續之品質監測，維護及提升照護品質。此外，鼓勵護理人員提升多國語言能力、醫院定期辦理相關教育訓練、提供政府機關相關資源之有效運用，皆能增進護病間之有效溝通，真正提升病人安全及照護品質。

Objective: The incidence of hospital-acquired pressure injuries in the internal medicine ward of our medical center in the first and second quarters of 2018 was 0.323% and 0.355%, respectively, which were significantly higher than the hospital’s target of 0.07%. Therefore, urgent improvement in the quality control and care indicators were required. The present study aimed to develop a program to reduce the incidence of hospital-acquired pressure injuries. Methods: A task force analyzed and reviewed the reasons for the high incidence of hospitalacquired pressure injuries in the ward. Then, it conducted education and training, distributed health information sheets and videos, provided tools for correct patient positioning, and formulated verification methods. Results: After the implementation of the project, the incidence of pressure injuries in the third and fourth quarters of 2018 and the first quarter of 2019 was 0.24%, 0.22%, and 0.14%, respectively. Although the target was not reached, the incidence rate gradually declined, thus indicating that nursing care for hospital-acquired pressure injuries improved. Conclusions: Taiwan society is aging, and the family structure has changed. Foreign caregivers often provide primary health care. Use of multilingual health instruction sheets and videos and quality monitoring improved the quality of care. In addition, encouraging nurses to study and improve their multilingual skills and providing them regular education and access to effective government resources and websites can improve medical communication, patient safety, and quality of care.