應用指標管理提升新生兒加護病房(NICU)早產兒照護品質

Improve the Quality of Care for Premature Infants in the Neonatal Intensive Care Unit (NICU) through Indicator Management

新生兒低體溫發生率是衡量新生兒死亡率的重要指標之一，據研究發現，若早產兒體溫低於36℃，死亡率高達64%，尤以極低體重早產兒風險更高。故維持極低體重早產兒體溫恆定，是新生兒加護病房早產兒照護品質的重要指標之一。

經由現況分析發現，造成本院極低體重早產兒入住新生兒加護病房一小時內低體溫發生率高的要因包含：轉送過程未使用加溫保暖設備、保暖設備功能不良、交班內容有所遺漏、護理人員認知不足及醫療團隊未掌握醫療相關資訊導致醫療處置時間過長等。因此透過軟硬體設備購置、流程設計、表單優化、相關教育訓練及指標管理應用等，減少極低體重早產兒低體溫的發生，進而提升新生兒加護病房早產兒照護品質。

 

The incidence of neonatal hypothermia is a crucial indicator of neonatal mortality. According to existing research, if the body temperature of a preterm infant drops below 36°C, the mortality rate can reach as high as 64%; particularly, preterm infants with extremely low birth weight are at an even higher risk. Therefore, maintaining a stable body temperature for preterm infants with extremely low birth weight is a key indicator of the quality of care in the neonatal intensive care unit (NICU).

An analysis of the status quo revealed several factors contributing to the high incidence of hypothermia within the first hour of admission to the NICU for preterm infants with extremely low birth weight in our hospital. These factors include the lack of use of warming equipment during transport, malfunctioning warming equipment, omissions in handover information, insufficient knowledge among nursing staff, and prolonged medical interventions due to the healthcare team’s failure to possess relevant medical information. Consequently, through the acquisition of appropriate equipment, design of workflow, optimization of forms, provision of relevant training, and application of indicator management, the incidence of hypothermia among preterm infants with extremely low birth weight can be reduced, thereby improving the quality of care in the NICU.