Pai-Yu Huang, Min-Hui Hong, Li-Juan Yang, Wan-Yu Chen, Mei-Chuan Wu, Chiao-Chin Ku, Ming-Ho Lee, Ping-Chih Shih

Objective: This study aims to enhance the completeness of emergency care skills among emergency department (ED) nursing staff, enabling them to respond swiftly and accurately to various critical situations in the high-pressure, fast-paced ED environment. The ultimate goal is to improve patient survival rates and the quality of care. Based on our hospital’s 2023 data, 86 cases of out-of-hospital cardiac arrest (OHCA) were managed, with a return of spontaneous circulation (ROSC) rate of 24.42% and a skill completeness rate of only 61.9%.

Methods: This study adopted the PDCA (Plan-Do-Check-Act) quality management model. Through video review and fishbone diagram analysis, 11 key factors affecting skill completeness were identified. These included delayed operation of the LUCAS device, poor communication, lack of technical proficiency, and insufficient application of Team Resource Management (TRM) techniques. Accordingly, three major improvement strategies were developed:1Educational Golden Shield – Promoting systematic training and videobased instruction.2.Realistic Simulation Show – Incorporating TRM techniques and realistic scenario-based training.3.AI Era, Precision in Action”– Developing AI-assisted tools to enhance time management and procedural accuracy.

Results: Through a series of targeted trainings and simulation exercises, the completeness rate of emergency skills among nursing staff improved to 100%, and the ROSC rate for OHCA patients increased to 29.4%, demonstrating the effectiveness of the implemented strategies.

Conclusion and Discussion: This study confirms that integrating the PDCA management cycle, TRM techniques, and digital tools can effectively enhance emergency nursing skills and team collaboration. This, in turn, improves clinical response efficiency and the overall quality of emergency care. It is recommended that this approach be expanded to other medical units to further elevate emergency care performance and patient safety.

黃沛榆，洪敏慧，楊梨涓，陳婉玉，吳美娟，古巧琴，李明和，施秉志

目的：本研究旨在提升急診室護理人員急救技能的完整率，使其能於高壓、瞬息萬變的急診環境中，迅速且準確地應對各類緊急情況，進而提升病患存活率與照護品質。以本院 2023 年資料為例，處理 86 例到院前心跳停止病人，恢復自發性循環率為 24.42%，急救技能完整率僅 61.9%。

方法：本研究採用PDCA品質管理模式，透過影像回溯與魚骨圖分析，釐清11項影響技能完整率的關鍵原因，包括LUCAS裝置操作延誤、溝通不良、技術不熟練及TRM（團隊資源管理）技巧運用不足等。據此擬定三大對策：一、「教育魔法金鐘罩」推動系統化訓練與影像教學；二、「真人模擬實境秀」導入TRM技巧與擬真演練；三、「AI時代 精準到位」開發急救輔助工具，強化時間管理與操作正確性。

結果：透過一系列訓練與模擬演練，護理人員急救技能完整率提升至 100%，OHCA 病患 ROSC 率亦提升至 29.4%，顯示改善策略具明顯成效。

結論與討論：本研究驗證，結合 PDCA 管理流程、TRM 技巧與數位工具，能有效提升急診護理人員急救技能與團隊合作能力，優化臨床應變效率與急救品質。建議未來可擴大應用至其他醫療單位，以提升整體急救效能與病人安全。