提升手術室完訓護理師非預期心臟手術技能

Improving the Skills of Operating Room Nurses in Assisting with Unplanned Cardiac Surgery

心臟手術風險及複雜度高，手術室心臟外科護理師專業技能會影響手術病人安全和手術品質。本專案旨在提升心臟外科完訓護理師執行非預期手術技能；調查完訓護理師執行非預期心臟手術技能完整率僅50.1%，自信心5.1分，焦慮8.1分；原因為體外循環流程與儀器操作不熟悉、器械醫材複雜易遺漏忘記、缺乏經驗和輔助工具等。經客制化心臟外科醫材、器械及醫師個別習慣明細表，視覺化顏色標示儀器操作步驟、實質獎勵、修正新人教育訓練及定期教育、持續監測、體外循環簡易流程海報、教學影片等，完訓護理師執行心臟手術技能完整率提升93.7%，自信心提升8.1（滿分10分），焦慮降為6.4分（滿分10分），故適當輔助工具及政策，可提升手術室完訓護理師專業技能和自信心，且作為類似單位參考。

The professional skills of operating room nurses may affect the surgical safety and quality of the operation. This program aimed to improve the skills of operating room nurses who had completed training in the cardiac surgery department and who would assist with unplanned cardiac surgeries. The responses to the questionnaire survey indicated a completion rate for performing skills in unplanned cardiac surgery of only 50.1%. The mean self-evaluated confidence score was 5.1 points out of 10. The mean anxiety score was 8.1 points out of 10. The reasons for low scores included being unfamiliar with procedures and instruments, the complexity of the equipment and materials used in cardiac surgery, and lacking experience and auxiliary tools to facilitate the procedures. Solutions include the use of customized cardiac surgery materials and equipment charts, detailed lists of physicians' preferences, colored labels indicating the steps of each procedure, and a reward scheme. Also, training, continuous medical education, process surveillance, posters illustrating key procedures for extracorporeal circulation surgeries, and training videos were recommended. After the improvement plan was implemented, the completion rate of performing skills in cardiac surgery increased to 93.7%. Mean self-evaluated confidence increased to 8.1 points out of 10, and anxiety dropped to 6.4 points out of 10. Therefore, with appropriate auxiliary tools and strategies, the professional skills and confidence of operating room nurses can be improved to help aid in better surgical quality. This may serve as reference for similar units in improving certain skills.