提昇骨外科術後病患自控式止痛使用成效之改善專案
Project to Improve the Effects of Patient-controlled
Analgesia for Patients after Orthopedic Surgery
余美蓮;魏良琪;蔡美娟;涂淑貞;張文英 摘要 本專案旨在提升骨外科術後病患自控式止痛使用成效。在資料收集的過程中發現 病患對自控式止痛的使用並不了解，導致對 PCA 之滿意度低；僅 48%，同時因 護理人員對 PCA 的熟悉度低只有 44%，故無法立即解決 PCA 所致之問題；再者，
又因本院缺乏 PCA 衛教單張與 PCA 機器異常警訊處理流程，以致病患對 PCA 之使用成效不佳，故成立本專案小組，經過專案解決辦法，如完成表單製作、儀 器簡易操作及異常處理規範、建立標準作業流程、舉辦在職教育等實施後，結果 顯示病患對 PCA 之滿意度由原來 48%提升至 92%，而護理人員對 PCA 之熟悉度 亦由原來 44%提升至 100%，達本專案目的。本專案之實施在臨床工作上不僅有 效的改善病患術後疼痛的問題，也縮短護理人員處理 PCA 發生異常時之時間， 進而提升病患滿意度及護理品質。 Abstract
The aim of this project was to improve the effects of patient-controlled analgesia (PCA) for patients after orthopedic surgery. During data collection, several problems were identified including that patients did not understand how to use PCA after surgery, resulting in a low 48% of patient satisfaction. Moreover, with only 44% nurses familiar with PCA, they could not solve PCA problems immediately. Lack of educational pamphlets, machine errors, and managerial procedures were also
identified as problems in this project. Therefore, an improvement team was formed to solve problems. After completing documentation forms, machine manuals,
establishing error management standards and standard project procedures, and holding continuing education for nurses, patient understanding of PCA improved from 48% to 92%. Nurses' familiarity with PCA also increased from 44% to 100%. Implementation of this project not only significantly reduced patients' pain after surgery, but also shortened the time for dealing with errors related to PCA use. Finally, patient satisfaction and quality of nursing care were improved.
