提升加護年資二年以下新進護理師連續性靜脈血液透析過濾術照護能力

Enhancing the Care Abilities of New ICU Nurses with Less than Two Years of Experience in Continuous Venovenous Hemodiafiltration

本專案旨在提升加護年資2年以下新進護理師，連續性靜脈血液透析過濾術照護能力。單位加護年資2年以下新進護理師佔50%，不熟悉連續性靜脈血液透析過濾術照護，延遲病人治療及造成資深護理師負荷，引發改善動機。經分析原因為課堂講授生硬、警報不會處理、缺乏實際練習及在職教育。透過翻轉、擬真教學、遊戲競賽、行動裝置APP做為課後複習及操作指引。連續性靜脈血液透析過濾術照護認知正確率由62%進步到92.8%，達專案目標84%，技術操作正確率由36.9%提升至92.3%，達專案目標73%。附帶成效裝機時間由32分鐘縮短至24分鐘。結果顯示翻轉教學及APP有效運用於護理教學，提升重症單位連續性腎臟替代療法照護品質。

This project aims to enhance the care competencies of newly employed nurses with less than two years of experience in continuous venovenous hemodiafiltration (CVVHDF). In the unit, 50% of the nurses have less than two years of experience and are unfamiliar with CVVHDF care, leading to treatment delays for patients and increased workload for senior nurses, which motivated this improvement initiatives. Root cause analysis identified issues such as rigid classroom teaching, inability to handle alarms, lack of practical training, and insufficient on-the- job education. Solutions included flipped teaching, simulation-based training, gamified competitions, and the use of mobile apps for post-class review and procedural guidance. As a result, the correct cognitive response rate for CVVHDF care improved from 62% to 92.8%, surpassing the project goal of 84%, while the technical operation accuracy rate increased from 36.9% to 92.3%, exceeding the target of 73%. Additionally, the setup time was reduced from 32 minutes to 24 minutes. These results demonstrate that flipped teaching and mobile apps effectively improve nursing education and enhance the quality of care for continuous renal replacement therapy(CRRT) in intensive care units.