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題名 | 怎麼確保加護病房之病患嚴重度資料完整正確=Integrity of Data Collected to Assess Severity of Illness in Intensive Care Units |
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作者 | 陶阿倫; | 書刊名 | 醫療品質 |
卷期 | 1:1 1998.05[民87.05] |
頁次 | 頁1-12 |
分類號 | 419.39 |
關鍵詞 | 收集資料; 品質管理; 治療性介入計分系統; 急性生理改變及慢性健康狀態評估; 加護病房; Data collection; Quality assurance; Therapeutic intervention scoring system; Acute physiology and chronic health evaluation; Intensive care; |
語文 | 中文(Chinese) |
中文摘要 | 計分系統是用來評估進入加護病房病人的嚴重度以及護理人員的工作負荷量。本研究在報告,使用TISS及APACHE兩個計分系統,我們如何達到完整而正確的資料記載的經驗。兩個表格設計的目標,在減少表格的數目及刪除重複的查驗項目。每日由電腦列印的報表,對於遺漏的表格做一檢討及改進。從中發展出兩個指標:TISS 指標(100 ×當月出加護病房病人的遺漏表格數╱當月出院病人住院總天數),及APACHE指標(100 ×靠病歷補足資料的表格數╱當月住院總人數)。雖然TISS表格自1996年1月就開始使用,但此一研究的第一個月(1996年9月),52.7%(330/626)的表格遺漏,有33.7%(35/104)根本沒有任何資料記錄。經過三個月的摸索實驗,到1996年12月,此比率就分別下降到5.2%及2.0%。APACHE指標(須靠病歷補足資料的比率),持續改善到1997年5月就下降到6.3%(6/96)。在採用新系統後,所有的病人(100%)現在都能取得 APACHE 的資料了。 |
英文摘要 | Scoring systems are used to assess the severity of the problems of patients admitted to intensive care units and the workload of the nursing staff. This study reports our experience in achieving complete and accurate data for the APACHE (Acute Physiology And Chronic Health Evaluation) and TISS (Therapeutic Intervention Scoring System) scoring systems. Two forms were designed with the objective of minimizing the number of forms to complete and the duplication of data collection. Feedback with daily printouts of missing forms were generated by computer. Two indicators of success were developed: a TISS indicator (100 × number of missing forms from patients discharged from the ICU that month/sum of length of stays in the ICU of each patient discharged from the ICU that month), and an APACHE indicator (100 × number of charts retrieved from medical records/number of patients admitted to the ICU that month). Although the TISS forms had been in use from January 1996, the results for the first month of this feedback were 52.7% (330/626) of forms were missing, with 33.7% (35/104) of patients not having any data recorded at all. Over the three-month trial period, from October to December 1996, these figures improved to 5.2% and 2.0% respectively. The APACHE indicator (number of charts that had to be retrieved from medical records to complete data) continued to improve, dropping to 6.3% (6/96) by May 1997. After instituting the new system, all (100%) patients now have APACHE data. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。