提升約束病人照護認知

Improved Awareness Concerning Restraint Patients

在加護病房中，病人身上經常會有各種的管路，工作人員為了避免病人拔管，或是工作的方便考量，『身體約束』行為幾乎無法避免。因此，身體約束如何運用和避免濫用是值得審慎考量的問題。本專案的目在探討如何提升約束病人的照護認知，進而減少病人的合併症產生。經由本專案資料分析結果發現：(1)缺乏約束相關資訊；(2)不知何時該約束；(3)缺乏有效溝通；(4)缺乏約束前衛教。依據問題分析、擬定改善措施為：文獻研讀、舉辦在職教育、讀書會、舉辦學習後認知測試、制定約束標準流程、發展約束評估記錄表單、設計溝通工具、制定衛教單張、宣導海報。對策實施後，約束率由55.6%下降至41.1%，約束產生合併症比率由18.8%下降6.3%，經由此專案：減少約束合併症的產生、約束率下降、提升醫護人員對身體約束的照護認知及重視，進而維護病人安全及提升照護品質。

In the intensive care unit,patients often have several kinds of tubes.The staff’s job is to stop patients from removing tubes,with consideration given to convenient issues.The use of”Physical Restraints” can not be avoided. Therefore , how to avoid physical restraints to be abuse is the problem worth careful consideration. The purpose of this project was to explore how to increase the care cognition of restraint patients , while decreasing complications. By analyzing results of the project data found:(1)Lack of information related to restraints ;(2)Do not know when restraints should be used;(3)Lack of effectual communication;(4)Lack of teaching before using restraints.According to analysis the problems could be lessened by:reference reviews,hold in-service education,study conferences,hold the cognition test after learning,establish standard of restraints,develope recording paper of evaluating restraints,design communication tools,establish teaching papers,publicize the poster.After executing these strategies,the numbers concerning the use of restraints dropped from 55.6% to 41.1%,the rate of complications due to restraints dropped from 18.8% to 6.3% .From these results we can see that decreasing the use of restraints helps patient safety and improves the quality of care provided.