運用多元教學，提升急診二年期護理人員急救復甦處置完整性之專案

Application of a Diversified Curriculum In Promoting Understanding of First-Aid Resuscitation in ER for Two-Year Post Graduate Nurses

急救處置是一項急診護理師必備的專業技能，過程中，每一執行步驟若有任何錯誤或時間延遲，都可能會危及病人的生命安全。根據單位醫師及組長針對急救過程回饋報告中，指出本單位2 年內新進護理人員對急救復甦流程不熟悉且對自己擔任的職責角色不了解，常出現工作重複執行，甚而影響急救進行，因此成立專案小組深入探討並進行改善。2017 年6 月專案小組調查發現二年期護理人員對急救復甦處置認知答對率僅為63%，對急救復甦處置操作完整率僅為48.8%，分析原因主要有：對急救用物準備、急救設備儀器、急救藥物準備和給藥流程及對急救流程的不熟悉；不清楚個人角色功能及職責；欠缺情境模擬機會；以及教學方式單調等。專案小組透過設計創意口訣、製作多媒體影片、多元化課程設計及急救模擬情境案例演練等解決方案的擬定及實施後，發現二年期護理人員急救復甦處置認知答對率由63% 提升至95%，急救復甦處置完整率由48.8 % 提升至96%，成效顯著。期盼藉由改善專案的推行，促進新進護理人員護理專業知識與技能，提供高品質的臨床照護能力，以達到良好的照護品質。

"The ability of providing first-aid resuscitation to critical patients is an important and necessary skill for all nurses working in the emergency department. Any mistake and delay could result in devastating consequences affecting patients’ safety and outcomes. Nevertheless, from the feedback reports of doctors and team leaders, most new nurses working at the emergency department for less than 2 years are not familiar with the process of resuscitation. Very often they do not understand their role and duty during the process, resulting in repeating orders or even slowing down the resuscitation flow. In order to tackle this issue, we established an ad hoc group to help better understand the reason behind this problem and hopefully provide a solution. In June 2017, survey showed that two-year post grad nurses only score 63% on first aid knowledge test and 48.8% in degree of completion of a full resuscitation process. Reasons behind the unsatisfactory scores included not being familiar with the preparation of equipment, use of medications, and process flow; fail to understand his/her role and responsibilities; and lack of opportunities to practice when using tedious classroom teaching method. Through designing mnemonics, using videos and multimedia tools, and diversified curriculum involving scenario with simulation practice, we were able to increase first aid knowledge score from 63% to 95% and 48.8% to 96% in degree of completion. By implementing these teaching methods, we can improve professional knowledge and skills among ER nurses, thus improve the quality of clinical care."