多元教學提升加護病房護理人員譫妄評估能力

Strategies for Improving Delirium Assessment by Intensive Care Unit Nurses

加護病房病人的譫妄是急性腦部功能障礙，持續嚴重會導致死亡，藉由早期評估發現，提供相關照護預防譫妄發生。研究單位護理人員譫妄評估執行正確率48.89%、譫妄照護認知正確率為63.60%。現況分析：護理人員對譫妄認知不足及譫妄評估技能不熟悉、缺乏譫妄護理評估標準作業指導書。專案目的欲提升加護病房護理人員對譫妄評估正確率及認知率達80%。對策措施：舉辦重症譫妄評估一系列多元的教學活動、制定重症譫妄護理評估標準作業指導書及資訊化譫妄評估量表等，提升護理人員對譫妄評估與認知能力。執行後，譫妄評估執行正確率84.66%、譫妄照護認知正確率為96.30%，可見有效對策實施，提升加護病房護理人員譫妄評估之能力。

Delirium in patients in the intensive care unit (ICU) is a reversible acute brain dysfunction that can be fatal if not promptly treated. However, only 63.60% of nurses at the study hospital were aware of delirium and how to assess patients for its symptoms. Consequently, delirium prevention measures were administered in only 48.89% of delirium cases in the unit. The present study conducted an analysis to identify the reasons for these deficiencies and identified several areas for improvement, specifically, the lack of knowledge about delirium, the lack of ability to assess the symptoms of delirium, and the lack of standard procedures to treat patients with delirium. This study employed several measures to improve ICU nurses’knowledge of delirium and increase the implementation of delirium assessment, comprising developing a management protocol for delirium in the ICU, establishing a standard evaluation routine, conducting bed-side teaching, and utilizing an informational delirium assessment scale. Following the implementation of these measures, the nurses’knowledge of delirium increased from 63.8% to 96.30%, and the implementation rate of delirium assessment increased from 48.89% to 90.54%. This study provides a model for training nurses to assess and treat delirium that enhances the quality of care patients receive.