提升護理師執行心血管重症處置準備期之技術

Enhancing Technical Proficiency of Nurses in Preparing Cardiovascular Critical Care

近年來跨科部照護需求漸增，本單位心臟專科性護理技術需求增加，若護理師無法正確備物與儀器設定，恐影響病人安全。本單位護理師對心血管重症處置準備期之技術正確率偏低，分析原因包括：（1）護理技術備物學習參考資源不足（34.9%）；（2）對技術不熟悉，缺乏實際操作經驗（26.2%）；（3）醫材放置混亂（19.8%）；（4）不清楚技術需要準備哪些用物（19.1%）。透過舉辦實作工作坊與在職課程、製作圖卡手冊與教學影片之學習工具、設置技術便利包、創建「加護智能LINE群組」、重置用物醫材擺放等策略，將準備期之技術正確率由19.1 %提升至95.2%，總耗費時間由18.9分鐘減至4.6分鐘。持續追蹤成效，技術正確率可維持96.7%，我們計劃將這些成功的策略，推廣至其他加護單位，以提升重症照護品質。

In recent years, due to the growing complexity of diseases, there is an increasing need for interdisciplinary care. If nurses fail to properly prepare consumables and set up equipment in medical treatments, patient safety will be affected. The technical proficiency of nurses in preparing for cardiovascular critical care treatment is low. The reasons in analysis include: 1. Insufficient reference materials for learning nursing techniques (34.9%). 2. Lack of familiarity with technology and insufficient practical experience (26.2%). 3. Disorganized placement of medical consumables and equipment (19.8%). 4. Uncertainty about the required consumables for specific techniques (19.1%). By implementing strategies such as organizing practical courses and workshops on cardiovascular critical care techniques, creating step-by-step illustrated manuals, recording instructional videos, set up a technical convenience kit, launching the ICU Intelligent Line Group, and reorganizing the placement of medical consumables and equipment, we successfully increased the accuracy rate from 19.1% to 95.2%, and the total time spent reduced from 18.9 minutes to 4.6 minutes. Continuous monitoring of the results has maintained the technical accuracy at 96.7%. The strategy is expected to be immediately extended to other intensive care units to improve the quality of critical care.