手術室護理人員執行骨科手術前用物準備改善方案

Strategies to Improve Preoperative Preparation of Orthopedic Surgical Instruments

劉淑惠(Shu-Hui Liu) ； 劉貞秀(Chen-Shiu Liu) ； 李美德(Mei-Ti Lee) ； 楊勝舜(Sheng-Shun Yang) ； 張淑娟(Shu-Chuan Chang)

《高雄護理雜誌》 28卷2期 (2011/08) Pp. 22-32

https://doi.org/10.6692/KJN-2011-28-2-3

摘要

本專案目的為改善手術前用物準備不齊全之問題，避免手術時間延遲而影響病患權益與安全。自2008年3月至10月施行，分析用物準備不齊全之主要原因包括（一）人員方面：護理人員對骨科手術所需備用物不熟悉。（二）制度方面：缺乏骨科手術用物準備標準流程圖、缺乏骨科醫師手術慣用物品本。（三）物品方面：包布管理不善。藉由改善方案如備用物品在職教育、訂定骨科手術前用物準備標準流程、骨科醫師手術慣用物品本、包布送消毒登記本。結果顯示骨科手術前用物準備時間，由每台18分47秒縮短為13分53秒，包布缺失率由100%降至27.3%，手術前用物準備不齊全率由50%降至11.4%。透過專案實施，提高用物準備齊全率，有效縮短病患接受手術整體時間，增加護理服務品質，提升手術醫療照護之安全性。

關鍵字

骨科手術 ； 術前用物準備

並列摘要

The purpose of this project is to develop a strategy aiming at reducing the inadequate preparation of surgical instruments before orthopedic surgery to ensure patient safety. From March 2008 to October 2008, standard procedures for preoperative orthopedic surgical instrument preparation, documentation of individual orthopedic doctors' commonly-used surgical instruments, and documentation of sterilization date of wrapped fabric were established. In the meanwhile, continuous education, surgical instrument-checking demonstration, and senior nurse check-up randomly on nursing staff were executed. At the end of the study, the orthopedic surgical instrument preparation time was reduced from 18'47” to 13'53”, wrapped fabric miss rate was reduced from 100% to 27.3%, and surgical instrument and equipment incomplete preparation rate had decreased from 50% to 11.4%. This study demonstrated that the implementation of the designed strategies was able to shorten preoperative orthopedic surgical instrument preparation time and improve the adequacy of preoperative preparation of surgical instruments.

並列關鍵字

Orthopedic surgery ； preoperative preparation of surgical instruments