提昇婦科手術全期護理執行率方案

Improving Application Rate of the Perioperative Care in Gynecological Operating Room

本手術室自2001年推行手術全期護理模式，提供手術病患個別性照護，深受病患及醫師肯定，顯示手術全期護理模式是符合病患需求的照護模式。然手術全期護理執行率逐漸遞減，本專案旨在提昇手術全期護理執行率，專案實施前執行率平均57.6%，針對手術全期護理執行率降低問題提出解決方法，包括制定訪視工具、調整訪視時間、建立手術全期護理標準與監測制度，專案實施後執行率提升為87.5%。執行中最大困難在於手術排程的變動與人力的彈性應用，如能獲得行政管理者於排班及醫療科部在排程上的配合，將使手術全期護理模式得以落實並廣泛推行。建議在推動之前必先建立一個符合專科需求的訪視工具，由專科逐步推動以降低困難度。

Perioperative care has been implemented in the gynecologic operating room for the past three years, providing individualized nursing care, and winning affirmation from the patients and the surgeons as well. However, the application rate of the perioperative care has been declining. In this project, we designed a preoperative visiting instrument, rescheduled visit hours, established perioperative standards and quality control. The application rate rose from 57.6% to 87.5% before and after this project. The most difficult areas encountered were frequent changes of operative schedules and flexibility of manpower. We suggest that application rate will increase gradually by using perioperative visiting instrument, arranging nurse scheduling properly, frequent communications and discussions with each department. Hopefully the experience from this project will be recognized, accepted, and applied.