提升加護病房開心手術後病人心臟復健運動之執行率

Enhancing the Achievement Rate of Cardiac Rehabilitation for Patients Undergoing Open Heart Surgery in the Intensive Care Unit

本研究旨在提升加護病房開心手術病人心臟復健運動的執行率。心臟復健運動已被證實能有效降低心臟疾病病人的死亡率和發病率，並提升病人的生活品質。然而，觀察結果顯示，本院心臟外科加護病房2022年5月至7月期間，開心手術拔管後病人的心臟復健運動執行率僅為38.4%。因此，成立專案小組並進行一系列改善措施，包括制定術後病人心臟復健運動作業流程，舉辦在職教育課程，增加護理人員對心臟復健的認知，並設置合適的輔助設備。
專案改善後，調查結果顯示，2023年6月至8月，心臟復健運動執行率從38.4%提升至92.0%，達成專案目標。此外，護理師對心臟復健認知正確率由32.3%提升至92.7%，病人下肢肌肉力量和活動能力顯著改善，平均住院天數從9.0天下降至6.5天。本研究證明，透過多項策略介入和跨團隊合作，可有效提升開心手術病人的心臟復健運動執行率，進而促進病人的康復和生活品質的提升。

This study aimed to improve the achievement rate of cardiac rehabilitation exercises for post-cardiac surgery patients in the intensive care unit (ICU). Cardiac rehabilitation exercises have been shown to effectively reduce mortality and morbidity in patients with cardiovascular diseases and improve their quality of life. However, observations revealed that from May to July 2022, the achievement rate of cardiac rehabilitation exercises following extubation in our hospital's cardiothoracic ICU was only 38.4%. To address this issue, a project team was formed to implement a series of improvement measures, including establishing standard operating procedures for postoperative cardiac rehabilitation exercises, organizing in-service education sessions, increasing nursing staff awareness of cardiac rehabilitation, and providing appropriate assistive equipment.
After implementing the project, survey results indicated that from June to August 2023, the achievement rate of cardiac rehabilitation exercises increased from 38.4% to 92.0%, achieving the project's target. Additionally, nurses' accuracy in recognizing cardiac rehabilitation principles improved from 32.3% to 92.7%. Patients demonstrated significant improvements in lower limb muscle strength and mobility, and the average length of hospital stay decreased from 9.0 days to 6.5 days. This study demonstrates that multifaceted interventions and interdisciplinary collaboration can effectively enhance the achievement rate of cardiac rehabilitation exercises for post-cardiac surgery patients, thereby promoting recovery and improving their quality of life.