運用翻轉教學提升畢業後訓練護理師對腦室外引流管照護知能

Enhancing NPGY's Competency of External Ventricular Drain Care Through Flipped Classroom Teaching

腦室外引流管是神經外科加護病房術後重要管路，若2年期護理師之新進人員（nurse post-graduate year, NPGY）臨床照護能力不足時，容易對病人安全造成影響。分析原因包括：口述教學與臨床照護所需知能不符、缺乏操作經驗、缺乏系統性教學及缺乏學習工具等。為提升NPGY腦室外引流管照護能力，改善策略包含製作教學影片、建構線上互動學習平台、製作腦室教具、規劃在職教育訓練、安排情境模擬課程，透過翻轉教學策略進行學習，以及建立可信賴專業活動（entrustable professional activities, EPAs）照護能力稽核制度。介入後，NPGY照護腦室外引流管認知正確率由60.5%提升至92.8%；技術操作正確率由62%提升至100%。顯示運用翻轉教學策略與照護能力稽核制度，有助於提升執行腦室外引流管臨床照護認知與技術。

The external ventricular drainage (EVD) is a crucial postoperative conduit in neurosurgical intensive care units. Insufficient clinical care competence among Nurse Post-graduate Year (NPGY) staff can jeopardize patient safety. Analysis reveals reasons such as discrepancies between verbal instruction and clinical care needs, lack of operational experience, systematic teaching, and learning tools. To enhance the proficiency of NPGY in EVD care, improvement strategies include creating instructional videos, establishing an online interactive learning platform, creating ventricular teaching aids, planning in-service education training, arranging scenario-based simulation courses, implementing flipped classroom teaching for learning, and establishing a reliable Entrustable Professional Activities (EPAs) care competence audit system. NPGY's EVD care cognitive accuracy increased from 60.5% to 92.8%, and technical proficiency rose from 62% to 100%. This demonstrates that employing diverse teaching strategies and a care competence audit system can enhance their performance in EVD clinical care cognitive and technical skills.