縮短急診啟動體外循環系統置入時效

Reduce the Time to Percutaneous Cardiopulmonary Support (PCPS) Placement in Emergency Situations

盡早使用體外循環系統有效提升病人存活率，單位2019-2020年啟動體外循環系統共12件，僅有1件啟動置入至運轉時間小於30分達成率8.3%而存活率僅16%，故成立專案小組以縮短體外循環系統建置時間為目的，經現況分析及真因探究擬定改善方案：一、PCPS專用區及整合PCPS用物；二、舉辦PCPS實務演練workshop；三、制定血液淨化小組連絡簡化流程設置；四、拍攝PCPS流程教學影片；五、完成PCPS標準作業程序及團隊角色工作分配、人員位置圖；六、舉辦教育訓練及測試；七、制定循環機設置整合機制，啟動體外循環系統至運轉小於30分鐘達成率由8.3%提升為71%，達專案目的，有效縮短建置時間，增加急診團隊信心及成就感。

Increasing patient survival rates through the early utilization of extracorporeal circulation systems is paramount. Between 2019 and 2020, there were a total of 12 instances of initiating extracorporeal circulation systems, yet only 1 case achieved a start-up time of less than 30 minutes, resulting in a completion rate of 8.3% and a mere 16% survival rate. Consequently, a dedicated task force was established with the primary objective of reducing the setup time for extracorporeal circulation systems. Following a thorough analysis of the current situation and an exploration of the underlying causes, the following improvement strategies were devised:
1.Establish a specialized area for Percutaneous Cardiopulmonary Support (PCPS) and integrate PCPS equipment.
2.Organize practical PCPS workshops.
3.Simplify the contact process for the blood purification team.
4.Develop instructional videos outlining the PCPS procedures.
5.Finalize standardized operating procedures for PCPS, delineate team roles and responsibilities, and allocate personnel positions.
6.Conduct educational training sessions and assessments.
7.Implement an integrated mechanism for setting up circulation machines.
By implementing these measures, the completion rate for initiating extracorporeal circulation systems within less than 30 minutes surged from 8.3% to 71%, successfully achieving the project's objectives. This not only effectively reduced setup times but also bolstered the confidence and sense of accomplishment among the emergency medical team.