提升急診嚴重特殊傳染性肺炎防護作業之完整率

全球遭受新型冠狀病毒肆虐，各醫院為疫情進行防堵作業，本專案旨在提升急診嚴重特殊傳染性肺炎防護作業之完整率。調查發現急診室嚴重特殊傳染性肺炎防護作業之完整率僅78%，分析主要原因為：不清楚正確穿脫個人防護裝備、缺乏防疫技能訓練、未標示進出負壓隔離室的動線、防疫政策宣導無即時傳遞及回饋機制、標準作業流程與現況疫情不符等。改善策略包含：舉辦防疫技能在職教育、標示進出負壓隔離室動線、增設防疫專用LINE群組、製作及張貼穿脫個人防護裝備海報及新增標準作業流程等。經專案改善後，急診嚴重特殊傳染性肺炎防護作業之完整率由78%提升到100%，達專案目的，亦將此防護作業平行推展至本院門診及分院急診，不僅落實醫院防疫政策，並確保病人於疫情期間之就醫安全。

關鍵字

急診；嚴重特殊傳染性肺炎；防護作業

並列摘要

Because of the emergence of the COVID-19 pandemic, hospitals are implementing protection procedures against COVID-19. This study evaluated strategies to improve the correctness of protection procedures against novel coronavirus infections in the emergency department. Several employees in the emergency department are not familiar with the correct steps to put on or put off the isolation gown. An inappropriate isolation protocol is not suitable for preventing virus transmission. The correctness rate of protection procedures against COVID-19 infection in our emergency department was low. The reasons included unfamiliarity with the sequence of putting personal protective equipment, unclear marking of when the staff should be in and out of the isolation ward, not updating the CDC's latest policy in time, not providing feedback, and lack of complete education. We conducted brainstorming sessions and a literature review to identify strategies for addressing these issues. The strategies included conducting on-the-job training, marking lines for moving in and out of the isolation ward, increasing the particular line group for pandemic prevention, and developing improved operating procedures. The implementation of these strategies significantly increased the correctness rate of protection procedures against COVID-19 infection in the emergency department from 78% to 100%. This rate exceeded the project goal and was the result of cross-team cooperation. These strategies can be implemented in outpatient and emergency departments in parallel, which can lead to an improvement in the hospital's pandemic prevention policy and in patient safety during the pandemic.

並列關鍵字

emergency ； COVID-19 ； protection procedures

參考文獻

陳竺誼、周書安、趙子瑛、林資諺、鄒心茹（2021）．提升急診護理師防疫能力之改善專案．榮總護理，38(3)，231-240。

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Dexter, F., Parra, M. C., Brown, J. R., & Loftus, R. W. (2020). Perioperative COVID-19 defense: An evidence-based approach for optimization of infection control and operating room management. Anesthesia and Analgesia. 131(1), 37-42.

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Nadarajan, G. D., Omar, E., Abella, B. S., Hoe, P. S., Shin, S. D., Ma, M. H.-M., & Ong, M. E. H. (2020). A conceptual framework for emergency department design in a pandemic. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 28(1), 1-13.

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