臺灣醫學中心放射線科檢查流程之病人安全調查

Survey of Patient Safety in the Examination Process of Diagnostic Radiology Departments at Medical Centers in Taiwan

陳榮邦(Wing P. Chan) ； 賴映蓉(Ying-Jung Lai) ； 陳震宇(Cheng-Yu Chen) ； 張政彥(Cheng-Yen Chang) ； 林明芳(Ming-Fang Lin) ； 李三剛(San-Kan Lee) ； 黃國茂(Kuo-Mou Huang)

《中華放射線醫學雜誌》 32卷4期 (2007/12) Pp. 193-203

摘要

本研究目的在瞭解台灣各醫學中心放射線科檢查流程之病人安全機制施行現況。
參照ACR期刊中Swensen與Johnson提出之放射檢查流程，經修改為八個步驟，建立監控病人安全指標措施與預防之問卷，郵寄17家醫學中心，藉此了解各醫學中心放射科對病人安全機制之實行現況。
樣本回收15份(88%)，醫院認為最重要的病人安全監控項目依序為：核對病人身分、對病人做口述衛教或注意事項說明、顯影劑滲漏紀錄（平均每年每家醫學中心顯影劑大量滲漏2.38±2.22件，小量滲漏1.30±8.41件）、顯影劑過敏紀錄（嚴重過敏1.39±1.84件，輕微過敏63.85±51.43件）、建立高危險通報系統（佔13家醫院，平均每月通報率0.86±0.96%）等。
本研究結果提供各醫學中心放射線檢查對病人安全監控之現況，參酌專家意見後，將進一步提出我國放射線科病人安全流程指引，期望病人安全流程能落實至各醫院，並將列入醫院評鑑項目，以降低因流程造成的疏誤，促進病人安全系統的提升。

並列摘要

The aim of this study was to survey the current status of a patient safety index and preventive policy for the process of radiological examination in medical centers in Taiwan.
We translated the quality map reported by Swensen and Johnson in the Journal of American College of Radiology into eight steps, and from this reference, we designed questionnaires which were mailed to 17 medical centers in Taiwan.
The response rate was 88% (15/17). Items that were elected to be important to patient safety were, in order: to confirm the patient's identity; to inform the patients, orally, about health education or attention matters before the examination; to record and prevent contrast-medium extravasations (annual extravasations per medical center: large amount, 2.38±2.22 (mean SD); small amount, 11.30±8.41) and allergic reactions (annual reactions per medical center: severe, 1.39±1.84; mild, 63.85±51.43); to establish a reminder system for patients at high risk (13/15 hospitals; monthly reporting rate, 0.86±0.96%).
This study offers a survey of the current status of patient safety control during the process of diagnostic radiology examination. We recommend that our radiological society establish a guideline to promote patient safety in the radiological examination process at all hospitals in Taiwan.