提升內科加護病房護理人員執行俯臥通氣治療照護正確率

Increasing Nursing care Accuracy for Prone Ventilation Therapy in Intensive Medical care Units

目的
本單位護理人員執行俯臥通氣治療照護正確率僅59.2％，且壓力性損傷與溢奶發生率皆高達17.0％，此高併發症率再加上操作複雜性，導致照護團隊得面臨操作失誤與併發症發生的心理壓力，不僅影響治療效益，更恐危及病人安全。主要導因包括標準作業流程不符、護理認知技能不足，及減壓輔具與收納工具缺乏。故專案旨在透過提升護理人員的照護能力與技術熟練度，冀以有效降低壓力性損傷及溢奶等臨床合併症，進而改善病人安全與臨床照護品質。
方法
多層面介入策略包括設計「俯臥箱Easy Go」及引進合適的減壓輔具、修訂俯臥通氣治療標準作業流程，並導入「歐趴有聲書」與「俯臥通氣治療照護影片」進行在職教育，舉辦真人體驗營與定期情境模擬演練，以加強角色分工及團隊協作能力。
結果
專案介入6個月後，護理人員的認知正確率由71.4％提升至97.9％，照護正確率由59.2％提升至96.3％。臨床合併症發生率由原先各17.0％降至0.0％，且此成效持續維持5個月，順利達成專案目標。
結論
本專案有效提升護理人員技能與俯臥通氣治療之照護品質，顯示多層面介入策略具臨床實用性與可持續性，並將成功模式推廣至其他單位，作為臨床最佳實務範例。建議未來結合虛擬實境以優化教育訓練。

Purposes
The accuracy of nursing care for prone ventilation therapy was 59.2% in our unit, and the incidences of pressure injuries and aspiration were 17%. This high complication rate, together with the procedure complexity, placed substantial psychological pressure on the care team due to concerns regarding procedural errors and adverse events. This psychological pressure not only compromised treatment effectiveness but also potentially threatened patient safety. Key factors contributing to the low accuracy and adverse events included nonstandardized operating procedures, insufficient nursing knowledge and skills, and the lack of appropriate pressure-relieving devices and storage tools. Therefore, the aim in this study was to enhance the care competencies and technical proficiency of nurses to effectively reduce clinical complications such as pressure injuries and aspiration, thereby increasing patient safety and overall quality of care.
Methods
A multifaceted intervention strategy was implemented, which included developing the Prone Box Easy Go, introducting suitable pressure-relieving devices, revising of the standard operating procedures for prone ventilation therapy, and implementating in-service education through audiobooks and instructional videos on prone ventilation care. In addition, hands-on experience training sessions and regular scenario-based simulation drills were conducted to strengthen role clarity and team collaboration.
Results
After six months of implementation, the knowledge accuracy of the nurses increased from 71.4% to 97.9%, and care accuracy increased from 59.2% to 96.3%. The incidence of clinical complications decreased from 17% to 0%, and these improvements were sustained for five months, successfully achieving the project goals.
Conclusions
This project effectively enhanced nursing competencies and the quality of care in prone ventilation therapy, demonstrating that a multifaceted intervention strategy is clinically effective and sustainable. The successful model has been extended to other units as an example of best clinical practices. Future efforts should consider integrating virtual reality technologies to further enhance education and training.