降低術後恢復病人過夜留滯率

Reduce Overnight Patients' Stagnant Bed Rate in Postoperative Recovery Room

因重症病人增加及加護中心床位不足，造成麻醉手術後病人當日無法轉出而留滯於恢復室。病人嚴重留滯恢復室會延遲常規手術進行，造成護理人力需求增加及影響院方營收。專案發現造成恢復室病患嚴重留滯原因有：一、無恢復室滯床處理原則因應嚴重滯床所導致之負面影響，二、麻醉狀況解除後，外科醫師仍要求病人留滯恢復室不可轉出，三、加護中心床位不足，無法適時收住術後需加護照顧之病人。執行改善措施如：建立恢復室滯床處理流程，避免延遲常規手術進行及人力不足問題；設置「恢復室病人留滯評估單」評估病人病情變化，作為轉出恢復室之依據；統計及提供滯床數據，作為醫院增設加護中心床位之依據。執行改善措施後，每日平均滯床率由28.6%降低為10%。

This project aimed at overnight patients' stagnant bed rate in Postoperative Recovery Room(POR). Because of the critical illness of the patients and the beds in intensive care unit (ICU) being insufficient, the postanaesthesia surgery patientswere unable to exit fromthe POR on the same day.The negative results of stagnant beds are postponing regular surgery and increasing the cost of nursing manpower.The main reasons of stagnant bedswere: no regulatory police to dealwith this problem, after postanesthesia observation, the surgeon presumed subjectively that patients needed to stay in POR, and no available beds in ICU for postoperation patients.The improvement measures were as follows: (1)Establishing procedures todeal with stagnant beds to avoid delaying regular surgery and the problemof insufficient manpower, (2)Designing a "POR stagnant evaluation sheet" to evaluate the changing of patients' condition as the basis of exiting POR, (3) Compiling stagnant bed statistics and providing data for the hospital as a basis for ICU beds.After carrying out these improvementmeasures, the stagnant bed ratewas reduced to 10% from 28.6%.