經橈動脈心導管檢查穿刺部位瘀青發生率改善方案

The Project of Improving Ecchymoses Rate in Tranradial Artery Catheterization Percutaneous Radial Artery Approach for Coronary Angioplasty

歐惠容(Wai-Yung Au) ； 張惠敏(Hui-Min Chang) ； 曾紅枝(Hung-Chin Tseng)

《榮總護理》 26卷1期 (2009/03) Pp. 81-89

https://doi.org/10.6142/VGHN.26.1.81

摘要

本專案目的為降低經橈動脈心導管檢查穿刺部位瘀青發生率，於2006年1月至6月調閱157位經橈動脈進行心導管檢查病人穿刺部位發生瘀青有67人，平均瘀青發生率42.6%。經真因驗證分析瘀青發生主要原因為：醫師穿刺技術不統一、止血設備不良、護理人員衛教未確實所致。擬定改善對策有：1.制定橈動脈心導管檢查衛教標準。2.制定新任總醫師動脈穿刺訓練制度。3.修改止血設備。4.制定橈動脈心導管檢查穿刺技術標準。5.制定橈動脈心導管檢查後止血技術標準。對策實施後，瘀青發生率由42.6%降為5.6%。本專案不僅降低穿刺部位瘀青發生率、提升病人滿意度，在疼痛及發紺率也有明顯改善，更促進跨科部間之團隊合作，提升病人安全及醫護照護品質。

關鍵字

經橈動脈 ； 瘀青率 ； 心導管檢查

並列摘要

The process security of tranradial artery catheterization approach for coronary angioplasty patients' safety would be more important. From January to June in 2006, there were 157 patients who were after the radial artery cardiac catheterization in our units, and among them, 67 patients had the incidence of ecchymosis, the average occurrence was 42.6 %.
The main reasons of the ecchymosis were the following: 1. Equipment for stopping bleeding was ineffective. 2. The puncture technology of doctors was not skillful. 3. The nursing staff's cognition was inconsistent. And the improvement measures were as follows: 1. To develop the standard procedure of radial artery cardiac catheterization education. 2. To establish the training system of arterial puncture for doctor before coronary angioplasty. 3. To modify equipment to stop bleeding. 4. To develop the puncture protocol of the radial artery. 5. To set up the standard procedure for stopping bleeding after catheterization. After implementation of the corrective measures, the ecchymosis rate decreased from 42.6 % to 5.6 %. The purpose of this project will not only achieve the goal, but also promote more cross-divisional cooperation between departments to enhance the patients' safety and health care quality.

並列關鍵字

tranradial artery catheterization approach ； ecchymosis rate