- 期刊
利用醫囑查詢降低移動式胸部X光攝影之重覆開單率
To Redeem the Redundant Prescription of Portable Chest X-ray by Using Physician Order Entry System
摘要
醫療輻射品質安全在社會大眾意識下不斷提升，放射師嚴格遵守最低的「合理抑低（as low as reason ableachievable, ALARA）輻射量」為職責。24 小時內重覆開立X 光檢查增加病人醫療曝露輻射劑量，並且造成醫療人力與成本浪費。本研究針對加護病房移動式X 光檢查，應用本院利用創建團隊資源管理（teamresource management, TRM）工具子程式住院移動式X 光醫囑清單查詢系統為工具，查詢是以有24 小時內已完成的胸部X 光，降低不必要X 光醫囑。研究對象為加護病房常規移動式X 光醫囑，使用住院移動式X 光醫囑清單查詢系統為工具，當有24 小時內重覆開單醫囑時先連絡開單醫師確定是否要執行醫囑。研究期間從提醒醫囑前從2014 年8 月至11 月共收集1017 例移動式X 光醫囑，其中93 例為24 小時內重覆開單，佔總比例9.14%。提醒醫囑後從2015 年1 月至5 月共收集1274 例移動式X 光醫囑，其中13 例為24小時內重覆開單，佔總比例0.7%。利用移動式X 光清單查詢系統可有效降低24 小時內醫師重覆開立醫囑，卡方檢定已達顯著水準，P-value＜0.001，故應用X 光醫囑查詢系統可有效降低X 光醫囑重覆率，達降低人力醫療資源與ALARA 原則。
並列摘要
The quality of the medical radiation dose has promoted continuously among the public consciousness. A radiological technologist abides by as low as reasonable achievable (ALARA) as his duty. It is not only to neglect to patient's radiation doses but also to cause to the waste of the labor and medical resources when the physician orders the repeated X-ray prescription within twenty-four hours. The main purpose of the study is aimed to the mobile X-ray examination in intensive care unit (ICU). The method is to make use of team resource management (TRM) program designed by the hospital as the order inquiry list system of the hospitalized mobile x-ray photography. The inquiry purpose is mainly to the finished chest X-ray examination within twenty-four hours to reduce the unnecessary X-ray order. The study object is the routine mobile x-ray order in ICU and the order inquiry list system of the hospitalized mobile X-ray photography as the means. If there are any orders which repeated within 24 hours, we have to contact the physician and ask him whether run the order or not. During the study period, from August to November 2014, the total of 1017 cases of the mobile chest X-ray photography, ninety-three cases are redundant prescription within twenty-four hours, the total percentage of 9.14%. After reminding of the redundant prescription, from January to May 2015, the total of 1274 cases of the mobile chest X-ray photography, thirteen cases are redundant prescription within twenty-four hours, the total percentage of 0.7%. The outcome shows that it is effectively to reduce the repeated order within twenty-four hours to use the order inquiry list system of the hospitalized mobile X-ray photography. Chi-square test indicates a significant level, P-value ＜0.001. Therefore, using the order inquiry list system of the hospitalized mobile X-ray photography, it can reduce the repeated rate of the X-ray order so as to attain to lower labor resources and get to ALARA principles.