提升裝置心室輔助器病人早期活動率

Improve the Early Mobilization Rate of Patients with Ventricular Assist Devices

心室輔助器為心衰竭末期病人等待心臟移植或延長生命之重要維生系統，加護病房術後積極照護和啟動早期肢體活動，可減少住院天數，改善病人生活品質；但重症單位須審慎評估與規劃早期活動，以維護病人安全。現況分析發現，本團隊在裝置心室輔助器病人術後早期活動的執行率僅有24.6%，主因為缺乏早期活動具體規範、教育訓練不足、活動評估項目繁雜、活動流程不熟悉，缺乏實務經驗、與團隊成員有效溝通不足。故本專案以跨團隊討論運用多元策略，如：制定早期活動準則與安全評估規範、舉辦教育訓練課程與情境模擬教學，及建立團隊溝通管道，除了將執行率提升至97.6%，過程中未發生不良事件，提供高品質且安全的術後照護。

The ventricular assist device (VAD) is essential for end-stage heart failure patients awaiting heart transplants or to prolong life. Proactive post-operative care and early limb movement in intensive care can shorten hospital stays and enhance patient quality of life. However, initiating early activity in critical care units requires careful assessment and planning to maintain safety. Analysis indicates our team's implementation rate for early post-operative activity in VAD patients was merely 24.6%. Contributing factors included lack of specific early activity guidelines, inadequate training, complex assessment criteria, unfamiliarity with procedures, insufficient practical experience, and poor team communication. To address these issues, this project implemented multidisciplinary strategies through cross-team discussions. Measures insscluded establishing early activity guidelines and safety assessments, providing educational training sessions, scenario-based teaching, and developing team communication channels. These initiatives successfully raised the execution rate to 97.6% without adverse incidents, offering high-quality and safe post-operative care.