以品管圈手法改善腦中風病人病房復健運動執行率

Improving the Execution rate of Rehabilitation Exercise in Patients with Stroke by quality control circle

腦中風復健黃金期為發病3－6個月內，此時期應加強復健。臨床發現除常規復健治療時間外，於病房執行復健活動者僅佔37.3％，非復健活動高達62.7％，本文旨在提升腦中風病人病房復健執行率。經問卷調查發現執行率低主因有：病人不知道做什麼、沒看到有人做、護理人員不知道怎麼教、無一致作業標準。介入改善措施為設立復健計畫表、製作復健教材宣傳海報、設立復健教材櫃、舉辦復健在職教育、拍攝床邊被動關節運動影片、明訂固定復健時間並撥放音樂、制定活動監測表及標準流程。措施執行後病人夜間復健執行率由37.3％提升至87.8％，改善具顯著成效，提升病人夜間復健執行，病人獲得更完善照護，在附加效益方面，量性效益病人整體滿意度調查由94.43％提升至96.65％，質性效益獲病人讚美大幅增加，此結果期提供臨床照護上的參考。

The golden period of stroke rehabilitation is within 3-6 months of onset, and rehabilitation should be strengthened during this period. In addition to the time of routine rehabilitation treatment, clinical findings found that only 37.3% of patients performed rehabilitation activities in the ward, and 62.7% of non-rehabilitation activities. This article aims to improve the execution rate of ward rehabilitation in patients with stroke. The questionnaire survey found that the main reasons for the low implementation rate were: patients did not know what to do, did not see someone do it, nursing staff did not know how to teach, and there was no consistent operating standard. Intervention improvement measures include setting up rehabilitation plans, making posters of rehabilitation teaching materials, setting up rehabilitation teaching materials cabinets, holding rehabilitation on-thejob education, shooting passive joint motion videos at bedside, specifying fixed rehabilitation time and playing music, and formulating Activity monitoring form and standard process. After the implementation of the measures, the implementation rate of patients' night rehabilitation was increased from 37.3% to 87.8%. The improvement had significant results. The patients' night rehabilitation was improved. The patients received better care. In terms of additional benefits, the quantitative benefit patient satisfaction survey was increased from 94.43 % Was increased to 96.65%, and the qualitative benefit was greatly increased by the praise of patients. The results will be the reference for clinical care.