- 期刊
提升照顧者執行接觸隔離防護措施正確率
Program to Improve the Accuracy Rate of Caregivers Implementing Contact Isolation Protection Measures
摘要
本單位2014年院內感染密度平均為（千分之3），比全國的（千分之2）高。發現照顧者於接觸具抗藥性菌種之病人時，執行接觸隔離防護措施不正確，故成立本專案小組。確立原因：（一）照顧者接觸隔離防護措施認知錯誤及未提供團體衛教；（二）護理人員接觸隔離防護認知錯誤、衛教內容不一致、缺乏在職教育；（三）缺乏抗藥性菌種接觸隔離防護衛教單張、病室標示及穿脫流程圖；（四）缺乏稽核。故執行改善策略，照顧者接觸隔離防護措施正確率由40%提升至88%，單位之院內感染密度降低，降為2015年3月的（千分之0.9）及4月為（千分之0）。執行過程遭遇照顧者意願不高及外籍看護工語言溝通障礙之困難，建議未來發展多媒體及多國語言之衛教教材，以增加照顧者及外籍看護工對於接觸隔離防護的了解，提升執行正確性及減少抗藥性菌種傳播，進而提升照顧品質。
並列摘要
In 2014, the average nosocomial infection density in this ward was (3 per mille), which is higher than the national (2 per mille). It was found that when the caregiver contacted patients with drug-resistant strains, the implementation of protective measures for contact isolation was incorrect, so this program was established. Reasons for establishment: (1) caregivers misunderstand the isolation protective measures and failure to provide group health education; (2) nursing personnel exposed to isolation to prevent cognitive errors, the contents of health education are inconsistent, and the lack of on-the-job education; (3) lack of drug-resistant bacteria contact isolation protective health education leaflet, ward indicator and diagram of gear on and off procedure; (4) lack of auditing. After the implementation of improvement strategies, the correct rate of the procedure of caregiver contact isolation protection improved from 40% to 88% and the average nosocomial infection density within the unit went down to (0.9 per mille) in March and (0 per mille) in April was recorded. However, we found the difficulties in the implementation as some caregivers expressed low motivation and language barriers shown in foreign nursing workers. In the future, it is recommended to develop multimedia and multi-lingual health education materials in order to increase the understanding of caregivers and foreign nursing workers about the protection of contact isolation. Hence improve the accuracy of implementation and reduce the spread of drug-resistant strains to enhance quality of care.