- 期刊
降低全身麻醉氣管內管插管病人術後喉嚨中重度疼痛率改善專案
Project to Reduce the Rate of Moderate to Severe Postoperative Sore Throat in Patients With Endotracheal Tube Intubation Under General Anesthesia
摘要
全身麻醉手術時會以氣管內管插管維持病人呼吸道順暢，但可能導致呼吸道損傷造成術後喉嚨痛。本專案因連續發生病人術後嚴重喉嚨疼痛的抱怨事件，調查發現全身麻醉氣管內管插管病人術後喉嚨中重度疼痛率達43.3%。專案小組經現況分析調查確立主要原因為固定氣管內管氣囊壓力及監測作業未標準化、麻醉醫師插管時潤滑劑使用認知不同、輔助工具及物料不敷使用、缺乏衛教輔助資源、缺乏稽核改善機制。執行改善策略為統一固定氣管內管氣囊壓力監測、取得潤滑劑使用一致性共識、製作全身麻醉衛教單張、修訂氣管內管插管病人安全作業流程及制定稽核表、制定稽核機制。專案實施後，病人術後喉嚨中重度疼痛率從43.3%降至30.0%，有效提升麻醉照護品質。
並列摘要
In general anesthesia surgery, endotracheal intubation is used to maintain the patient's airway smoothness, which may cause respiratory tract damage and cause postoperative sore throat. This project was initiated as a result of continuous complaints from patients regarding severe postoperative throat pain. After investigation, it was found that patients with endotracheal intubation under general anesthesia had a moderate to severe postoperative throat pain rate of 43.3%. A task force investigated the current situation and determined the main causes as endotracheal tube balloon fixation and monitoring operations not being standardized. Issues identified included: Anesthesiologists different perceptions of lubricant use during intubation; inadequate use of auxiliary tools and materials; a lack of auxiliary resources for health education; and a lack of audit and improvement mechanism. The methods implemented for improvement included: unifying airbag fixation and monitoring methods; obtaining a consensus on the use of lubricants; producing patient information leaflets; revising the safety operation process of endotracheal intubation; and developing an audit process on endotracheal intubation. After the execution of the improvement strategy, the occurrence of postoperative sore throat dropped from 43.3% to 30.0%, demonstrating effective improvement in the quality of anesthesia care.