運用多元策略降低一般病房身體約束率

Reduce the Physical Restraint Rate of General Wards with Multiple Strategies

身體約束成為了預防意外事件發生優先考量的措施。本院護理管理部訂定一般病房身體約束目標為0.26%，檢視2021年度全院身體約束率，未達目標值的有八個單位，佔全院一般病房身體總約束率的四成，故成立專案小組訂定改善措施。經現況分析發現造成身體約束率高之原因後，擬訂改善策略為1.規劃多元身體約束教學訓練課程、2.製作身體約束高風險因子評估工具、3.制定身體約束評估流程。專案小組介入改善措施後，八個病房身體約束發生率由0.56%降至0.22%，執行過程中護理師對於身體高風險因子評估工具有著相當的認同，表示此評估量表可以協助臨床有客觀工具用於約束的評斷憑據，期望將身體約束量化評估工具平行推展至各單位，提高身體約束的品質，達成健康照護環境之目標。

Physical restraint has become a key measure for preventing patient accidents. According to data from the Nursing Management Department, the physical restraint rate was 0.26%. An analysis identified several contributing factors, prompting the development of targeted improvement strategies, including: (1) implementing multiple training and education courses, (2) creating a physical restraint high-risk factor assessment scale, (3) establishing a standardized clinical assessment process, and (4) optimizing the physical restraint reporting system. Following the implementation of these measures, the physical restraint incidence across eight wards decreased from 0.56% to 0.22%. During this process, nurses positively acknowledged the high-risk factor assessment scale as a valuable tool for evaluating the need for restraint in clinical settings. The scale provides an objective method for assessing restraint risks, supporting more consistent and evidence-based decision-making. It is anticipated that this quantitative assessment tool will be adopted across additional units, enhancing the quality of physical restraint practices and promoting a safer healthcare environment.