提升呼吸加護病房護理人員譫妄評估正確率

Improving the Accuracy Rate of Delirium Assessments for Nurses in the Respiratory Intensive Care Unit

目的
提升呼吸加護病房護理人員譫妄評估正確率，強化護理人員譫妄警覺性，儘早啟動譫妄評估，降低病安事件發生。
方法
譫妄評估資訊化、設計創意譫妄評估流程表、譫妄特徵圖像卡及舉辦在職教育，推行譫妄評估於重症資訊系統；設計提醒工具：流程表結合口訣及創作歌詞利於評估、將譫妄評估中問題化為簡易圖像卡輔助溝通，縮短評估時間；舉辦課程搭配評估示範影片加深記憶。
結果
統計本單位2021年8月譫妄評估正確率僅59.6％，在專案實施後提升至97.6％且效果維持良好。
結論
藉由本專案介入後，能幫助護理人員快速掌握譫妄評估技巧，評估時長自平均6.6分鐘，大幅度縮短至2分鐘，有效提升評估速度及改善護理人員譫妄評估正確率，期望此結果可提供臨床譫妄評估技能參考運用，提高醫療照護品質。

Purposes
The objective of this study is to improve the accuracy of delirium assessment among nurses in the Respiratory Intensive Care Unit (RICU), enhance their vigilance towards delirium, and enable early assessments to reduce patient safety incidence.
Methods
Our strategies encompassed several key elements, including digitizing delirium assessment information, designing a creative delirium assessment flowchart, developing delirium feature image cards, and conducting in-service education. We integrated delirium assessment into our RICU information system, incorporating reminder tools like a mnemonics flowchart and original lyrics to facilitate assessment. We transformed the complex delirium assessment questionnaire into easy-to-understand image cards to streamline communication and reduce assessment time. Furthermore, we organized training courses with assessment demonstration videos to enhance retention.
Results
Statistical data reveals that the accuracy rate of delirium assessment was merely 59.6% before the project initiation in August 2021. Following the successful implementation of the project, this rate significantly improved to 97.6%, and it has consistently remained at this level.
Conclusions
The implementation of this project has achieved remarkable results, empowering nurses to rapidly attain expertise in delirium assessment. The significant reduction in assessment time, decreasing from an initial average of 6.6 min to just 2 min, demonstrates a substantial improvement in assessment speed and an increase in the accuracy rate of delirium assessments performed by our nurses. We expect these outcomes will serve as a model for comprehensive delirium assessment training, ultimately elevating the quality of medical care.