降低腫瘤病房轉型COVID-19專責病房護理人員工作壓力之專案

A Quality Improvement Project for Reducing Work-Related Stress of Nurses in Converting an Oncology Ward Into a Designated COVID-19 Ward During the COVID-19 Pandemic

背景：2021年5月因嚴重特殊傳染性肺炎於台灣本土爆發社區感染，短期間內，大量確診的COVID-19病人，對醫療照護系統容納量的需求也增加。為了應對本院治療的大量COVID-19病人的湧入，設立了疫病專責病房。腫瘤病房接到院方指示須立即轉置改為疫病專責病房，在大流行期間與感染科病房合併以因應嚴峻疫情，因此，從病房設置、人員訓練到獨立照顧確診病人，以及與感染科病房工作人員的相處磨合的過程等，對於護理師造成莫大的負擔及壓力。目的：本專案的目的是將腫瘤病房護理師的工作相關壓力指數從20.2分降低至15分以下。解決方案：採用交叉訓練、在職教育幫助腫瘤護理師學習對COVID-19病人的護理。此外，經專案小組分析現況後制定五項解決方案，及時討論並實施五項介入措施，包括：統一病房動線、環境優化、加強教育訓練、透過溝通平台方式進行不同意見進行討論、運用彈性排班策略。結果：Stress and anxiety to viral epidemics-9量表得分從20.2分降低到8.2分。結論：此專案內容及結果可作為日後遇到疫病大流行時非專責之一般病房轉型為疫病專責病房佈署之參考。

Background & Problems: The community spread of SARS-CoV-2 occurred during the COVID-19 pandemic in May 2021 in Taiwan. Due to the large number of COVID-19 patients, demand for healthcare capacity had also increased. In response to the massive influx of patients with COVID-19 in our hospital, a designated COVID-19 ward was established. In addition, the oncology ward was also quickly transformed into a designated COVID-19 ward that shared staff and work schedules with the originally designed COVID-19 ward during the pandemic period. The process of setting up the ward, training personnel, and providing independent care to COVID-19 patients and the period of professional cooperation with medical staff from the infectious disease ward caused great burden and pressure on nurses. Purpose: The objective of this study was to reduce the work-related stress index from 20.2 to 15. Resolution: Cross-training and in-service courses were implemented to assist the oncology nurses to learn nursing care for patients with COVID-19. Five solutions were discussed and implemented in a timely manner. The interventions included the unifying the logistical flows between wards, optimizing ward environments, providing education and training on COVID-19, launching a new communication platform to facilitate discussions and gather various opinions, and implementing flexible scheduling. Results: The stress index score declined from 20.2 to 8.2 on the stress and anxiety to viral epidemics-9 scale. Conclusion: The findings of this study may be referenced to assist nurses and nursing managers when making preparations to transform oncology wards into designed COVID-19 wards.