提升加護病房護理師譫妄評估結果正確率

Improving the Accuracy of Delirium Assessments Conducted by Nurses in Intensive Care Units

加護病房疾病複雜度高，譫妄是常見照護問題，重症患者譫妄盛行率達70%，嚴重者終致不可逆的腦損傷，甚而增加死亡率及醫療成本。經專案小組查檢發現加護病房護理師譫妄評估整體執行結果正確率為65%，導致譫妄問題遭擱置及延誤治療，故成立專案小組改善。
專案小組經依據文獻資料並下載CAMICU標準版教材，評估臨床可行性包含：舉辦譫妄評估實際操作課程、建立譫妄評估多媒體資訊、制定執行規範、設計評估記錄表、建構譫妄評估監測機制等，經由實施改善策略後，加護病房護理師譫妄評估結果正確率由65%提升至100%，讓醫療團隊正視譫妄問題，即早介入並治療，盼此專案之改善能提供同屬性單位參考與借鏡。

The disease complexity is quite high in intensive care unit (ICU) patients, and delirium is a commonly seen issue. The prevalence of delirium in critically ill patients is 70%. In severe cases, irreversible brain injury can lead to increased mortality and medical costs. Upon examination of the ad hoc group, it was found that the overall accuracy rate of the delirium assessment by ICU nurses was 65%, which led to neglect and delay in treatment. The project team was established to improve and address this issue.
According to the literature and downloading the CAM-ICU standard manual, the project team evaluated the feasibility of including: organizing a delirium assessment practical course, creating multimedia information on delirium evaluation, defining implementation specifications, designing an evaluation record form, constructing a delirium evaluation and monitoring system, etc. After implementation of the intervention strategy, the accuracy rate of delirium evaluation by ICU nurses improved from 65% to 100%. This has allowed the medical team to promptly address the delirium issue with proper treatment. It is hoped that improvement of this project can provide a reference for similar units.