- 期刊
降低新興傳染病新病人收療流程不完整率
Reducing the Incomplete Rate of Admissions for New Patients with Emerging Infectious Diseases
摘要
單位因在2018年12月配合感染管制室進行新型A型流感演習計畫時，出現新興傳染病收療流程不完整率高達將近5成，分析發生原因包含：SOP未詳細描述工作內容，含接病人細節、備物內容、環境清潔順序；教學未強調收療新病人流程重要性，缺乏可提升學習動機之多元學習工具；脫除裝備順序複雜，標示僅文字描述部份技巧易疏忽；缺少實際操作練習及缺乏多元稽核工具及機制；備物內容物品多且分散，查檢表使用不便，研擬出（1）設計電子書進行教育訓練（2）重新錄製流程內容（3）重新修訂標準作業流程並製作手冊及海報展示（4）設計稽核表與制度（5）研發桌遊進行教學（6）建置防疫物品專車及備物圖卡。改善措施施行後新興傳染病人收療流程不完整率，由現況44.1％下降至1.4％，收療新興傳染病新病人認知正確率，由現況67.7％上升至95.3％。效果皆能持續維持於目標值，多元化教學策略成效良好，建議各醫療機構可依據單位特性建置教具，以利未來人員教育，使疫情有進展時，人員可快速自我學習。
並列摘要
In December 2018, when our unit coordinated with the infection control office to carry out the novel influenza A virus infections drill program, the incomplete rate of admissions for patients with emerging infectious diseases was nearly 50%. According to the analysis, the causes included the following: 1) The standard operating procedure did not describe the work contents in detail, including the details of receiving patients, the items to be prepared, and the order for cleaning the environment; 2) The teaching did not emphasize the importance of the new patient admission process and lacked diverse learning tools to enhance learning motivation; 3) The outfit removal sequence was complex, the labels only provided written descriptions, and some skills could be easily neglected; 4) There was a lack of practice drills as well as diverse auditing tools and mechanisms; 5) There were many items to be prepared, which were scattered, and the checklist was inconvenient to use. In response to these problems, we 1) designed an e-book for education and training; 2) re-recorded the process contents; 3) revised the standard operating procedure, and created a manual and a poster for display; 4) designed an auditing table and system; 5) developed a board game for teaching; and 6) set up special carts with epidemic prevention items and graphic cards showing the preparation of these items. After implementing these improvement measures, the incomplete rate of admissions for patients with emerging infectious diseases reduced from 44.1% to 1.4%, and the correct awareness rate about admissions of new patients with emerging infectious diseases increased from 67.7% to 95.3%. The effects could be maintained at the target values continuously, and the diversified teaching strategies achieved good results. It is suggested that all medical institutions refer to these measures, so that the support staff can learn by themselves quickly when an epidemic progresses.