精神分裂症病人入院初期照護品質之建立與評價

Development and Evaluation the Care Quality in Admission Phase for Schizophrenia Patients

精神分裂症病人入院初期由於缺乏病識感、被強制治療或肢體被約束而無法執行入院護理，護理人員又因工作忙碌而延遲給予，使得入院期照護完整性有待加強，經專案成員多重投票後確立問題為病人合作度不佳、新進人員訓練標準不一、缺乏照護標準化、交接班不完整、沒有稽核等五項，因此本方案目的為提昇精神分裂症病人入院三天內照護完整性達95%以上，經由實施照護標準建立、宣導及稽核等對策後，照護完整性由76.1%，提昇至99.6%，增加23.5%，目標達成率為124.3%，進步率為30.9%；交班完整性由實施前79.1%提昇至99.4%，增加20.3%，故將精神分裂症病人入院三天內之照護準則，納入常規護理作業系統，增加護理照護之一致性，確保照護品質。因此，本方案說明除建立照護標準外，尚需要定期稽核，方能落實執行，維持良好品質，建議可將其推廣至其他急性病房。

Patientswithschizophreniahadnoinsightsorphysical restraintswhiletheywereadmitted.Nursesmightforget to provide nursing care because they worked in shifts and were overloaded. The problems were:patients'noncompliance, no training standards, inadequate standards, incomplete care, and no audit ofpatient care. The purposes of this project were to raise the comprehensive rate to 95 percent in theadmission phase.The interventionswere to establish standards of care, andmonitor care quality.The finalcomprehensive care rate was increased from 76.1 to 99.6 percent. Therefore nursing standards in theadmission phase should be set into the routine care in order to maintain the quality of care. This projectdescribes establishing the standard of care, andmaintaining the quality bymonitoring care regularly. Theoutcomes also suggest that the standards of care can extend to other inpatient settings.