管路的种类.PPTVIP

提升管路安全留置品質 增修照護標準作業流程 教育訓練與評值 建立品管監測機制 研發病人及主要照護者指導工具與策略 針對警訊事件及通報案例進行醫療團隊的溝通及檢討改善 遵循標準化的步驟及checklists 使用 fail-safe 或有警報器的醫材 制定固定方法 貫徹無菌觀念 有多條管路時，清楚標記以預防打結或混亂 (spaghetti syndrome) 插 CVP 時用超音波定位 影像確認管路位置的正確性 新手使用Sim Lab假人練好工夫(插胸管或打CVP) 0.9% 醫療品質及安全照護 管路留置品質管理的成效 建立病人管路事件危險及評估工具 建立管路照護表 護理人員自學手冊 提高執行力及增加利潤 減少病人管路事件的次數，減少失敗成本及醫療糾紛，並縮短平均住院日數 行政管理 注重護理品質，保障病人權利 臨 床 病 人 提昇了護理人員對管路照顧及異常事件上的認識 研究確實回報的成效，提昇相關人員對研究方法的認知、增加本院的研究成果 。 增加人員正確處置的認知及流程順暢度，讓能正確提報數據及在工作上增加信心，作業易被肯定，提昇個人醫療品質及工作滿意度 醫護人員 教 學 研 究 * 積極的品質管理獲得 ? 提升病人滿意度，創造品牌形象 能給病人及醫院提供明確科部優異數據證明 提升醫院競爭優勢 創造出病患、醫護人員及醫院的三贏局面 1 Have a nice day……………..… * * * 期待 * * * UE increased the need for MV and ICU care. There was a moderate to high potentially modifiable risk factors for UE, suggesting unsatisfactory ICU practice. More in intentional, intentional less serious condition; more when nurse is away; UE increased the need for MV and ICU care. There was a moderate to high potentially modifiable risk factors for UE, suggesting unsatisfactory ICU practice. And accidental sicker, most MV and sedation and morning shiftwith UE need reintubation; reintubation LOS TDMV are longer. Retrospective; All UE were self extubations; 15 reintubation. Most with low levels of sedation in the hour preceding the extubation (mean Ramsay 2.42). Pt needing reintubation had higher Ramsay 2.85 than did not 2.0. Ramsay score correlated with the need for reintubation (r=0.423; p=.03. Of the 31 pts 27 were restrained at the time of extubations p0. 001. Nurses32.3% had less than 5 years’ experiencein nursing and 51.6% had less than 5 years’ experience in ICU care; 89% of extubation occurred when the nurse was away from the bedside. Sedative and analgesic dose in the 24 h before extubation did not differ significantly from those in the 2 h before extubation Impaired level of consciousness on admission to the ICU and the presence of nosocomial infection intensify the risk for unplanned extubation, even when physical restrain