應用團隊資源管理與擬真訓練提升急救流程完整率

Using Team Resource Management and Situational Simulation to Improve the Resuscitation Performance Completion Rate

背景：急救處置成效關乎病人生命安全。疫情期間發現本院急救儀器設備的操作不完整、無急救站位任務分配規範、動線與儀器設備定位無明確劃分、團隊成員默契不足、訊息傳遞不明確影響急診室急救流程完整率。
目的：本專案目的在於提升急診室急救流程完整率。
解決方案：透過製作備物指引卡與氣道專用車、設定急救各站位角色任務、設備定位與動線規劃、擬真訓練及團隊資源管理訓練等方式進行改善。
結果：急救流程完整率由69.1%提升至91.6%，且至2022年效果維持達98.1%。
結論：藉由團隊資源管理與擬真訓練等多元改善措施，可有效提升急救流程完整率與急救後的自發性循環恢復比率。

Background & Problems: Cardiopulmonary resuscitation is an important issue in patient safety. After investigation, we identified the causes of the low rate of resuscitation completion in our emergency department as: incomplete utilization of available first-aid equipment, lack of standards related to task allocation, unclear moving line and instrument placement, lack of teamwork, and poor resuscitation-related communications during the COVID-19 pandemic.
Purpose: The project aimed to improve the resuscitation performance completion rate.
Resolution: The project included designing equipment reminder cards and an airway car, designating specific responsibilities for each team member, establishing standard layouts and traffic flows, and providing situational simulation and team resource management training.
Result: After the intervention, the resuscitation performance completion rate had risen to 91.6% from the pre-intervention rate of 69.1%. This has since further risen to a relatively constant completion rate of 98.1%.
Conclusions: The implementation of the team resource management and situational simulation training intervention in our ED improved both the resuscitation completion rate and the rate of return of spontaneous circulation (ROSC).