提升心臟外科加護病房護理師葉克膜儀器照護正確率之改善方案率

Improving Clinical Care Competencies of Extracorporeal Membrane Oxygenation (ECMO) in Cardiovascular Surgical Intensive Care Unit

本專案目的為提升心臟外科加護病房護理人員葉克膜儀器照護正確率之改善方案。現況中發現護理人員葉克膜儀器照護知能僅38.4%，對儀器操作技能僅35.9%，備物完整後至儀器導管裝置完成需耗時60-90分鐘，導致治療時間延長，甚至病人死亡。綜合以上結果，進行本專案改善方案：1.安排護理人員進行在職教育；2.舉辦儀器模組操作演練；3.製作簡易版中文圖表操作手冊；4.製作多媒體教學光碟片；5.設立葉克膜儀器備物專用車；6.制訂葉克膜儀器品質監測。經本專案改善後護理人員對葉克膜儀器照護知能由38.4%增加至93.4%，儀器操作技能由35.9%增加至95.5%，且護理人員備物完整後至葉克膜儀器裝設縮短至28分鐘內完成，顯示此專案不但增加病人存活率，亦提升加護病房患者照護品質與安全之良好成效。

The purpose of this project was to improve clinical nursing competencies of extracorporeal membrane oxygenation (ECMO) in cardiovascular surgical intensive care unit (CVSICU). ECMO-related nurses’knowledge was only 38.4% correct, and ECMO instrument operation skill only 35.9% correctly. Nursing staff spent sixty to ninety minutes with preparing machine devices to setting the cannulation of ECMO. Based on the above results, the improvement plan of this project was carried out: educational training, instrument module operation practices, made a simplified Chinese version of operation manual and multimedia-assisted teaching videos, set an ECMO instruments device car, formulate the quality monitoring of ECMO equipment. After the implementation, the accuracy of ECMO knowledge raised up to 93.4% correct, ECMO instrument operation skill raised up to 95.5%. And after the nursing staff completes the preparation, it can be completed within 28 minutes to the installation of the ECMO equipment. This project significantly enhanced ICU nurses’performance on ECMO.