提升麻醉喉頭鏡葉片高層次消毒正確率專案

喉頭鏡葉片為臨床麻醉科重覆使用的物品，文獻提及消毒不正確易造成病患間交叉感染及插管時將病原菌帶入肺部的風險；基於醫院感染「零容忍」的需求，引發執行本專案改善的動機。經調查後發現，本科對於喉頭鏡葉片高層次消毒觀念及步驟仍有改善之處，現況分析後，發現問題為：（1）未制定喉頭鏡葉片消毒規範；（2）缺乏高層次消毒專業知識；（3）無明確查核制度；（4）環境設備不足。因此本專案目的旨在提升喉頭鏡葉片高層次消毒正確率。故針對現有問題擬定改善措施：（1）建立喉頭鏡葉片消毒標準規範；（2）安排教育訓練；（3）建立標準化查核機制；（4）改善消毒環境與設備。經由改善專案實施後，本院之喉頭鏡葉片高層次消毒正確率由31.3%提高至100%，護理人員對高層次消毒的認知正確率由33.3%提升至98.3%，專案改善成效可避免病患間交叉感染的機會及保障病患的就醫安全，同時也提升臨床護理人員感染控制的專業知識技能，進而確保醫療照護品質。

關鍵字

喉頭鏡；高層次消毒

並列摘要

The laryngoscope blade is recycling equipment in clinical anesthesia practice. The literature review indicated that if sterilization of laryngoscope were incomplete it would result in cross-infection among patients, and increases the risk of pulmonary infection during tracheal intubation. Based on the hospital policy of ‘infection zero tolerance', we motivated to implement this improvement project. Through investigation and analysis the situation, the high-level sterilization for laryngoscope blades were incorrect in anesthesia department. And problems were: 1. wouldn't set up procedure of the sterilization, 2. lack of knowledge of the high-level sterilization, 3. there is no check mechanism, 4. equipment are not available adequately. The aims of the improvement project were increased the accuracy of the high-level sterilization for laryngoscope blades. There were including: 1. establishment of standards regulation, 2. educated the staffs in knowledge, 3. establishment of the standardized check-out system, 4. improvement of sterilization the equipment. The improvement project effectively improve the high-level sterilization of laryngoscope blade in the correct rate to increase from 31.3% to 100% elevated and the acknowledge of the high-level sterilization in our nurses staff of the correct rate to increase from 33.3% to 98.3% elevated in order to avoid cross-infection between patients and to ensure medical safety. But also enhance the clinical nursing staff infection control of professional knowledge and skills, and thus to ensure the quality of medical care.