提升內科加護病房早期復健運動執行率

Enhancing Early Rehabilitation Exercise Implementation in the Medical ICU

醫療人員為優先處理病人急症問題，易忽略早期復健；本單位2023年1至3月早期復健運動執行率僅35.9%，恐造成重症後虛弱症，進而增加住院天數與醫療負擔。本專案目的為提升內科加護病房早期復健運動執行率，分析要因有在職教育與醫護人員認知不足、缺乏早期復健運動指引與照護規範、臨床工作量大、無適用管路固定用具與復健運動輔助工具、缺乏適合護理指導工具等。本專案透過跨團隊合作，建立內科重症病人早期復健運動指引、運用多元化教材進行護理指導與教育、增添管路固定帶與輔助工具、家屬納入復健運動執行團隊等措施，早期復健運動執行率提升至100%，達目標值。持續推廣各項措施，以減少重症病人重症後虛弱症之發生，儘早脫離呼吸器。

To prioritize addressing patients' acute issues, medical staff often overlook early rehabilitation. The early rehabilitation exercise execution rate within this unit from January to March 2023 was merely 35.9%, potentially contributing to intensive care unit-acquired weakness (ICU-AW), thereby extending hospital stays and increasing the medical burden. The objective of this project is to enhance the execution rate of early rehabilitation exercises in the medicine intensive care unit. Key factors identified in the analysis include insufficient in-service education and awareness among medical staff, the absence of early rehabilitation exercise guidelines and care standards, a heavy clinical workload, lack of appropriate tube fixation equipment and rehabilitation exercise aids, as well as inadequate nursing guidance tools. This project established early rehabilitation exercise guidelines for critically ill patients through inter-professional collaboration, utilized diverse teaching materials for nursing guidance and education, introduced tube fixation belts and auxiliary tools, and engaged family members into the rehabilitation exercise team. The implementation rate of early rehabilitation exercise increased to 100%, achieving the target value. Continued promotion of these measures may help reduce ICU-AW and support earlier ventilator weaning.