提升手術室護理人員執行戊二醛防護之正確率

Improving the glutaraldehyde performance accuracy rate in operating room nurses

祝秋屏(Chiu-Ping Chu) ； 謝春金(Chun-Chin Hsieh) ； 戴靜怡(Chang-Yi Dai) ； 岳淑芬(Shu-Fen Yueh) ； 吳秋樺(Chiu-Hua Wu)

《新臺北護理期刊》 19卷2期 (2017/09) Pp. 73-84

https://doi.org/10.6540/NTJN.2017.2.007

摘要

在手術室常使用戊二醛（glutaraldehyde）進行器械之消毒，如使用不當容易造成工作人員化學性傷害。因此本專案之目的為提升手術室護理人員執行戊二醛防護之正確率。經現況分析發現：護理人員執行戊二醛防護之認知僅56.4%，執行戊二醛防護正確率為36.6%，主要原因包括：對戊二醛防護認知不足、未正確穿戴防護用具、防護用具不齊全及取用不便利、未設置局部排氣裝置、沖眼設備未鄰近器械間、戊二醛防護教育訓練不足、欠缺標準作業規範及未定期監測。經由現況分析及文獻查證後擬定改善策略：制訂戊二醛防護標準作業規範、設置戊二醛防護標準盒、舉辦戊二醛教育訓練、增設置沖眼及淋浴設備及執行戊二醛防護定期監測作業。經以上執行措施後，護理人員執行戊二醛防護之認知提升為95.2%（↑38.8%），執行戊二醛防護正確率為95.8%（↑59.2%），顯示本專案實施後能有效提升護理人員對戊二醛的自身防護能力，增加對工作環境安全之認知，共同營造優質的工作環境。

關鍵字

戊二醛 ； 防護措施 ； 工作環境

並列摘要

The purpose of this project is to enhance the protective performance of operating room nurses to deal with glutaraldehyde. From current analysis, cognitive rate of protective performance in nurses dealing with glutaraldehyde is only 56.4% while correct execution rate is36.6%. The reasons of deviation mainly include lack of standard operating norms, lack of education and training, and not regularly monitored. Based on the current situation we draw improvement strategies, such as development of standard operating norms, protection education and training program, and glutaraldehyde protection set and regular surveillances. After the implementation of the above measures, the cognitive rate of protective performance of paramedics dealing with glutaraldehyde raised to 95.2% (↑38.8%), and the proper protection rate increased to 95.8% (↑59.2%). The implementation of this project can effectively enhance care personnel for their own protection from glutaraldehyde, increase awareness of safety working environment, and jointly create a high quality working environment.

並列關鍵字

glutaraldehyde ； protective measures ； the working environment

參考文獻

Chu, W., & Hsu, L. L. (2011). Developing practical knowledge content of emergency nursing.professionals. The Journal of Nursing Research, 19(2), 112-118. doi: 10.1097/JNR.0b013e31821aa0eb

González Jara, M. A., Mora Hidalgo, A., Avalos Gulin, J. C., López Albiach, M., Muñoz Ortiz, L., Torán Monserrat, P., & Esteva Ollé, X. (2013). Exposure of health workers in primary health care to glutaraldehyde. Journal of Occupational Medicine and Toxicology, 8(31), 1-6. doi: 10.1186/1745-6673-8-31

Moual, N. L., Varraso, R., Zock, J. P., Henneberger, P., Speizer, F. E., Kauffmann, F., & Camargo, C. A. (2013). Are operating room nurses at higher risk of severe persistent asthma? The nurses' health study. Journal of Occupational and Environmental Medicine, 55(8), 973-977. doi: 10.1097/JOM.0b013e318297325b

Norman, M., Valerie, H., Cao, T. D., Towanda, E., & Natalie, L. (2010). Alcohol high-level disinfectant. American Journal of Infection Control, 38, 205-211. doi: 10.1016/j.ajic.2009.08.009

王建楠、李璧伊（2015）‧醫院內危害物質戊二醛暴露之不良健康效應：系統性回顧與統合分析‧中華職業醫學雜誌，22（2），89-98。