提升心臟內科加護病房護理人員執行目標體溫管理認知及操作能力

Improving Nurses’cognition and operation ability of targeted temperature management in cardiac intensive care unit

目標體溫管理(Targeted temperature management, TTM)可顯著提升到院前心跳停止病人之存活率並減少神經損傷的影響。本專案目的在提升加護病房護理人員執行TTM的認知及操作能力。臨床觀察發現單位護理人員執行TTM過程發生異常，顯示照護經驗及能力不足，因而成立改善專案。現況分析發現單位內護理人員執行TTM的認知及操作正確率分別是71.8%及37.0%，偏低的原因包括缺乏相關教育訓練、無照護標準作業及操作手冊內容簡略。經專案小組舉辦專科教育課程、儀器操作說明會、制定照護標準作業、醫囑確認表及儀器操作指導手冊等改善策略，並將TTM認知及操作能力納入品質監控作業，結果顯示護理人員執行TTM的認知及儀器操作正確率分別提升至91.2%和93.8%。希望透過此改善專案，提升病人安全及照護品質。

Targeted temperature management (TTM) has been shown to significantly improve survival rates and neurological outcomes in patients with out-of-hospital cardiac arrest (OHCA). The purpose of this project was to enhance the knowledge and operational skills of cardiac intensive care nurses in performing TTM. Clinical observations revealed that the accuracy rates for TTM knowledge and operational performance among nurses were low, at 71.8% and 37.0%, respectively. Contributing factors included a lack of relevant education and training, the absence of a standard operating procedure, and an incomplete operation manual. The interventions implemented to address these issues included: conducting TTM continuing education sessions, holding seminars on TTM equipment, developing a standard operating procedure, revising the operation manual, and incorporating TTM knowledge and operational performance as key quality indicators for TTM care. As a result, the accuracy rates for TTM knowledge and operational ability increased to 91.2% and 93.8%, respectively. This project ultimately contributes to enhancing patient safety and improving quality of life.