骨科跨病房團體護理指導改善方案

The Action of Improving Effect of Across-Ward Group-Education in the Orthopedic Ward

本專案目的為提昇人工膝關節置換術病人跨病房團體護理指導的參與率。依據某醫學中心骨科病房2005年統計結果發現團體護理指導參與率只有38％，致使有62％的膝關節置換術個案須以個別護理指導方式完成術前護理指導，造成護理人力的耗損，及人員的負荷增加。分析問題原因為：主治醫師手術日改變、病人入院晚未能參與團體護理指導、缺乏跨病房團體護理指導的標準流程、及護理人員配合不佳等因素。故成立專案小組，提出之解決方案有調整跨病房團體護理指導日及時間、建立專責同仁主講並管控護理指導品質、跨病房團體護理指導流程標準化，結果呈現跨病房團體護理指導的參與率提高至76.3％，目標達成率148.4％，進步率100.8％；個別護理指導所花費的時間約為跨病房護理指導的2倍，團體護理指導比個別護理指導節省2230分鐘，具節省時間及人力的效益；對護理指導的滿意度由97％提昇至99.5％。

The purpose of this paper was to increase the attention rate of across-ward group educationfor total knee arthroplasty patients. Only 38% of patients joined the group education at the orthopedicward of the medical center in 2005. Analysis showed that some causes were that the datesof operation changed, the patients were admitted too late, and they lacked the standard process ofacross-ward group education, thus the nurses had less cooperation. Based on these causes, weestablished an action team to plan some interventions. These included adjusting the time and date ofacross ward group education, having a specified member leading the patient education class, andstandardizing the process. The outcome showed that the attention rate increased to 76.3%. Thegoal- reached rate was 148.4%, and the promotion rate was 100.8%. The result also indicated thatless time was spent in group education, saving about 2230 minutes during four months. Finallypatient satisfaction was increased from 97 to 99.5%.