提升兒童加護病房新進護理師ECMO之照護能力

Enhancing the Ability of Performing ECMO Care by the Novice Nurses at the Pediatric ICU

重症兒童使用體外維生系統（ECMO）屬於臨床危急狀況，當新進護理師執行ECMO照護能力不足時，將影響團隊運作及病人安全。藉由事件的分析及品質改善，發現新進護理師執行ECMO照護完成率僅61.3%，原因包括：缺乏臨床經驗及實作訓練、照護認知不足、對各項警訊處理流程不熟悉、相關設備種類多且流程複雜、缺乏相關學習工具、無系統性的教育訓練及未落實相關技術稽核。此次品質改善活動期望提升新進護理師執行ECMO之照護能力，改善策略包含：規劃教育訓練課程、製作影片結合翻轉教室教學、設置說明圖卡與照護手冊、舉辦情境模擬演練及建立照護能力稽核制度。經上述改善策略後，新進護理師執行ECMO照護完成率由61.3%提升至98.2%，將有助提升病人安全及重症照護品質。

"The use of extra-corporeal membrane oxygenation (ECMO) is for children in critical condition. When the novice nurses have insufficient capacity to perform ECMO care, it will affect team operation and patient safety. According to events analysis and quality improvement process, we found that the completion rate of performing ECMO care by novice nurses is only 61.3%. The reasons include: lack of clinical experience and practical training, insufficient nursing knowledge, unfamiliarity with troubleshooting, various equipment, complex procedures, and lack of related learning tools, no systematic education and training, as well as not implementing evaluation protocol. In this quality improvement activity, our goal is to increase the ability of novice nurses in performing ECMO care. The quality improvement strategies include: planning education and training courses, making videos combined with flipped classrooms, setting the illustration card and nursing manual, organizing scenario-based simulation exercises, and establishing a system to evaluate nurses’care ability. After the improvement strategies, the completion rate of performing ECMO care by novice nurses increased from 61.3% to 98.2%."