護理人員執行護理活動超工時之改善專案

An Improvement Project to Reduce Overtime Hours of Nursing Activities

護理人員超時工作對自身健康、病人安全等方面影響甚大，進而影響護理品質，故引發改善動機。本專案旨在建立標準化Kardex範本、重整交班流程、修訂交接班工作切割原則及跨部門與教學部進行資訊化醫療教育訓練等措施。現況發現：護理記錄重複繕打內容、下班前30分鐘開立醫囑、醫囑更改頻繁處理費時、整理Kardex費時、交接內容不一致及冗長且下班前承接病人、入院衛教及環境介紹繁雜耗時、初次入院收集資料繁瑣。透過跨部門合作，重新檢視臨床護理活動後，護理活動總工時由執行前275.8分下降至120.3分，其工時縮短效果顯著，降低無效性的護理活動，建議未來可將標準化Kardex範本簡化施行及推至跨部門合作，落實護理工作效能，更確實有效運用時間維護人員自身健康及提升病人安全。

Overtime work of nursing staff has a great impact on their own health and patient safety, which in turn affects the quality of care. This inspired motivation to improve the situation. The aim of this project was to create measures such as establishing a standardized Kardex template, reorganizing the handover process, revising the principle of cutting handover work, and conducting information-based medical education and training across clinical departments and teaching departments. Analysis of the current situation revealed several causes for overtime, including repeated typing of contents in nursing records, issuing doctor's orders 30 minutes before getting off work, handling frequent changes of doctor's orders organizing time-consuming Kardex, handing-over inconsistent and lengthy contents. In addition, hospital admissions, health education, environmental introduction, and collecting data for admission notes were complicated and time-consuming and usually started late After re-examining clinical nursing activities through cross-departmental cooperation and implementing the measures, the total working hours of nursing activities reduced from 275.8 hours to 120.3 hours. The effect of shortening working hours was significant. In order to reduce inefficient care activities, it is recommended that the future Standardized Kardex template can be simplified and cross-departmental cooperation should be promoted. Efficient nursing work not only lead to better health among staff but also improve the safety of the patients.