提升神經內科病房腦中風病人戒菸轉介率

吸菸是腦中風疾病重要危險因子，中風病人若持續吸菸易再次中風，故戒菸對腦中風病人極為重要。調查本單位2021年7-12月中風吸菸病人的戒菸轉介率僅有59.0%，希透過專案提升單位中風吸菸病人戒菸轉介率。調查病房25位護理師、31位醫師、1位專師及1位個管師協助轉介的經驗，分析轉介率偏低主因為：未規定要轉介、未宣導轉介流程；轉介窗口不明確、醫護人員不知道轉介對病人的幫助、未接受戒菸相關訓練、忘記轉介；負責人員困難主動發現符合條件個案。改善措施包括：修訂戒菸轉介標準流程並製作海報宣導、透過報表主動搜尋個案、舉辦在職教育。經改善後2022年6-12月單位符合轉介條件之中風病人共42人，實際轉介41人，戒菸轉介率提升至97.6%，效果維持期間轉介率可維持98.9%。

Smoking is an important risk factor for stroke. However, the issue of smoking cessation is often overlooked in the acute treatment of stroke. The average referral rate of smoking cessation among stroke patients from July to December 2021 was only 59.0%. Therefore, we hope to improve the referral rate of smoking cessation patients through this program. Investigating the referral experience of 25 nurses, 31 physicians, a nurse practitioner and a case manager in the ward, which found the main reasons for the low rate of referrals were analyzed as follows: referrals were not required by the facility and the referral process was not publicized; physicians and nurses were not aware of the referral window, the benefits of referrals for patients, lack of smoking cessation training, forgetfulness of referrals; and main managers had difficulty in proactively identifying patients who met the eligibility criteria. Improvement measures include: revising the standard process for referrals of smoking cessation and producing posters to publicize the process, proactively searching for cases through reports, and organizing in-service education. As a result of these measures, from June to December 2022, 42 stroke patients in the ward met the referral criteria, and 41 of them were actually referred. The smoking cessation referral rate increased to 97.6% and remained at 98.9% during the period of effect maintenance.