運用多元策略，提升護理人員COVID-19重症病人照護完整率

Applying Multiple Strategies to Enhance the Completion Rate of Critical Care in COVID-19 Patients

背景：2021年5月台灣新冠疫情首次爆發社區感染，本土確診數及重症個案急遽上升。在疫情衝擊下，醫療機構啟動專責單位收治病人。本院成立COVID-19專責加護病房，護理人員由各單位支援人員所組成，經現況分析發現護理人員執行COVID-19重症病人照護完整率為79.1%，歸納原因為無COVID-19重症照護規範、缺乏完整訓練課程、缺乏教具輔助練習、無實務手冊及滾動式資訊太多。 目的：護理人員對COVID-19重症病人照護完整率，由79.1%提升至93.5%，以維護照護品質與病人安全。 解決方案 本專案多元策略之改善方案包含：(1)舉辦線上教育訓練；(2)架設滾動式資訊共享平台；(3)錄製「零接觸QR code自助吧」教案；(4)製作實務「COVID-19武功秘笈」；(5)執行「穿著做」重症照護情境模擬訓練教案。 結果：經由專案實施改善後，護理人員對於COVID-19重症病人照護完整率，由79.1%提升至98.2%，表示介入措施的成效顯著。 結　論 藉由提供線上教案及重症照護情境模擬訓練教案等可行之多元改善措施，可有效提升COVID-19重症病人照護完整率。

Background & Problems: Taiwan entered the community transmission stage of COVID-19 in May 2021, with numbers of locally confirmed cases and critical cases increasing sharply. Medical institutions deployed special units to treat patients. In our hospital, a special COVID-19 intensive care units staffed with nursing personnel across various specialties was established. The rate of COVID-19 critical care completion among nurses in this unit was 79.1%. The reasons for non-completion were found to include limited intensive care standards for COVID-19; inadequate training, teaching aids, and practice manuals; and the overwhelming amount of new COVID-19-related information and updates. Purpose: The aim of this project was to increase the team’s COVID-19 critical care completion rate from 79.1% to 93.5%. Resolutions: Multiple strategies were implemented, including: (1) providing online education and training, (2) establishing a platform for sharing COVID-19-related updates, (3) creating a QR-code accessible COVID-19 reference database, (4) creating a COVID-19 practice manual, and (5) providing simulation training sessions on wearing personal protective equipment during critical care. Results: The critical-care completion rate for patients with COVID-19 infection increased significantly in this unit from 79.1% to 98.2%, which exceeded the project goal. Conclusions: Implementing a multi-strategy intervention that includes both online and simulation training may be effective in improving the critical care completion rate for patients with COVID-19 infection.