縮短顏面骨折導航手術前準備時間之專案

A Special Plan of Shortening the Preparation Time before the Facial Bone Fracture Navigating Operation

羅詒貞(Yi- Chen Lo) ； 王琦(Wang Chi) ； 賀倫惠(Lun Hui Ho) ； 陳玉潔(Yu-Chieh Chen) ； 戴秋玉(Chiu-Yu Dai)

《長庚護理》 29卷3期 (2018/09) Pp. 393-406

https://doi.org/10.6386/CGN.201809_29(3).0006

摘要

顱顏導航系統可提升術中骨折復位準確率，亦避免造成神經、血管等重要結構的損傷；於術中即時告知醫師重建是否到位及達到顏面對稱效果。現況發現導航手術準備時間平均43.7分鐘，造成原因：一、人員面：顏面骨折導航手術準備認知不足，材料用物準備、器械組裝及導航系統操作不熟悉。二、設備面：導航影像系統、器械材料無整合。三、制度面：無手術標準作業、在職教育訓練。改善方案: 規劃導航系統定點定位、設置顏面骨折導航手術專用盒、制定導航手術準備作業標準、製作導航手術準備影音光碟、舉辦在職教育訓練。改善後手術準備時間從43.7分鐘降至12.7分鐘，導航手術準備認知正確率由55%提升至92%，達到專案目的。有效縮短手術整體時間，提升手術醫療照護之安全性。

關鍵字

手術室 ； 導航手術 ； 術前準備時間

並列摘要

The craniofacial navigating system can increase the accuracy of fracture replacement in the operation and avoid damaging important structures like nerve and blood vessels; moreover, it can show the effects of replacement and the effect of facial symmetry in the operation. At present, the average preparation time of the navigating operation was 43.7 minutes, and the reasons for the long preparation time are as follows: 1) Staff: the staff have inadequate knowledge of the preparation for the facial bone fracture navigating operation and are unfamiliar with the preparation of materials, the equipment assembly and the operation of the navigating system; 2) Equipment: the navigating image system and the equipment are incomplete; 3) System: the operation standards and in-service training are unavailable. The improvement measures were as follows: planned a designated place for placement of the navigating system; established a special box for the facial bone fracture navigating operation; created standards for the navigating operation; made education discs about the navigating operation; and offered in-service training. After the improvement, the average preparation time reduced from 43.7 minutes to 12.7 minutes and the accuracy of the understanding of the preparation for the navigating operation rose from 55% to 92%, which met the objective of this special plan. The achievement of this special plan can not only shorten the operation time but also enhance the safety of medical care of the operation.

並列關鍵字

operating ； navigation surgery ； preoperative preparation time

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