運用虛擬實境訓練提升急救復甦後照護完整率

Enhancing Post-Resuscitation Care Completion Rate through Virtual Reality-Based Training

延遲啟動急救復甦後照護與神經預後不良，有著密切的關係。護理人員作為主要執行者，落實急救與否對病人的神經功能恢復具有決定性的影響。本研究為一項醫療品質改善（quality improvement，QI）計畫，旨在提升單位內急救復甦後照護之執行完整率。單位2021年新增照護流程後，照護完整率高達98.1%，但部分流程，例如：器械降溫速率>1.5°C／小時僅68.6%，顯示照護仍有落差。經調查發現：教學時間過長、缺乏可練習教材、缺乏教學一致性及學習回饋機制，影響急救復甦後照護完整率。為提升照護完整率，本研究採用單位內單組前後比較之研究設計（介入前後成效評估），由專案小組導入虛擬實境教學系統，結合情境模擬與回饋機制。在專案實施後，照護完整率由98.1%提升至100 %，平均教學時間減少，學員滿意度及測驗成績明顯提升，病人神經學預後改善至36.7%，顯示此教學方式具實用性與推廣價值。

Delayed initiation of post–cardiac arrest care is closely associated with poor neurological outcomes. As the primary providers, nurses play a decisive role in the implementation of post-resuscitation care, which has a critical impact on patients’neurological recovery. This study was conducted as a quality improvement (QI) initiative aimed at enhancing the completeness of post–cardiac arrest care within a single clinical unit. After the introduction of a standardized post–cardiac arrest care protocol in 2021, the overall care completion rate reached 98.1%. However, gaps remained in specific care processes; for example, only 68.6% of patients achieved a device-assisted cooling rate greater than 1.5°C per hour, indicating suboptimal adherence. A needs assessment identified several factors affecting care completion, including prolonged instructional time, lack of practice-oriented educational materials, inconsistency in teaching content, and the absence of structured learning feedback mechanisms. A unit-based, single-group before-and-after study design was adopted to evaluate the effectiveness of the intervention. The project team implemented a virtual reality (VR)–based educational system that integrated scenario-based simulation and feedback mechanisms. Following the intervention, the care completion rate improved from 98.1% to 100%. In addition, mean instructional time was reduced, while learner satisfaction and assessment scores increased significantly. The proportion of patients with favorable neurological outcomes improved to 36.7%. These findings suggest that VR-based education is a practical and scalable strategy for improving the quality of post-cardiac arrest care.