多元學習策略提升照顧服務員執行接觸隔離防護措施之正確率

Multiple Learning Strategies to Improve the Accuracy of Nurse Aides in Implementing Contact Isolation Precautions

抗藥性細菌感染不但會延長病人住院天數、增加醫療成本，甚至造成死亡，而本院合約照服員經常流動於各病房，若未落實接觸隔離防護措施，將可能成為隠形傳播媒介。現況發現照服員執行接觸隔離防護措施之正確率僅達64.9%，分析主因為：（1）照服員對接觸隔離防護措施不熟悉且認知不足（認知正確率88.4%）；（2）防護裝備不足；（3）未常規接受實作訓練與技術評核。經運用多元學習策咯如：提供接觸隔離防護裝備流程影片、舉辦在職教育、提供圖示指導單張、教導防護裝備不足之因應、辦理實作訓練及技術評核等。改善策略介入後，照服員接觸隔離防護認知提升至97.5%；執行正確率提升至90.5%，以期避免抗藥性細菌於院內散播，提升病人就醫品質及安全。

Drug-resistant bacterial infection will not only prolong the hospital stay of patients, increase medical costs, and even cause death. In our hospital contract nurse aides often move around in various wards. If contact precaution is not implemented, nurse aides may become invisible transmission vectors. At present, it is found that the correct rate of the nurse aide’s implementation of contact precaution is only 64.9%. The major problems were: (1) The nurse aide is unfamiliar with and lacks of knowledge about contact precaution (the correct rate of cognition is 88.4%); (2) Insufficient protective equipment; (3) They did not receive routine implementation training and technical evaluation. Through the use of multiple learning strategies, such as: provided a video of the process of contacting precaution protective equipment, arranged education, provided graphic guidance leaflets, taught how to cope with insufficient protective equipment, and conducted practical training and technical assessment. After the intervention of the improvement strategy, the nurse aide’s awareness of contact precaution increased to 97.5%; the execution accuracy rate increased to 90.5%. In order to avoid the spread of drug-resistant bacteria in the hospital, and improve the quality and safety of patients’medical treatment, multiple learning strategies can be used as an important education program among nurse aides in the healthcare facilities.