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提升隔離病房疥瘡照護正確率

Improving Accuracy of Care Provided to Patients with Scabies in Quarantine

摘要


疥瘡易造成群聚感染。2016年7月至12月疥瘡病人未完成治療期程即轉出至一般病房,造成其他單位同仁對隔離病房產生不信任感。故2017年4月稽核、觀察、訪談與問卷調查分析後,確認隔離病房疥瘡照護正確率低(38.8%)的要因為:靜置物品無統一放置處;隔離衣不足;衛教內容不一致;提早解除空間隔離;藥膏劑量及部位擦拭不正確;照護流程缺乏細項說明。為將正確率從38.8%提升至100%,小組於2017年5月至2018年3月,執行規範靜置物管理方法並規劃靜置處、改採拋棄式隔離衣、制定衛教單張、統一空間隔離的時間計算方式及制訂臨床照護流程等策略。結果疥瘡照護正確率達100%,建議持續將照護策略平行推展至院內其他單位。

關鍵字

隔離病房 疥瘡 照護流程

並列摘要


Scabies occur in clusters easily. From July to December 2016, the patients with scabies were transferred to the general ward without completing their treatment, which caused distrust toward the isolation ward staff. Therefore, auditing, observation, interviews and questionnaire surveys were conducted in April 2017, and the researchers identified low accuracy of 38.8% of care provided to patients with scabies in the isolation ward. The causes included uncertain placement of infested articles, insufficient isolation gowns, inconsistent content of patient education, premature termination of spatial quarantine, inaccurate ointment doses and inappropriate body application, and lack of detailed care procedures. To improve the accuracy of care from 38.8% to 100%, from May 2017 to March 2018, the research team implemented standard management storage of infested articles in designated placement locations, use of disposable isolation gowns, development of a uniform patient education sheet, definition of accurate calculation of spatial quarantine time periods, and development of the clinical care process. As a result, the accuracy of scabies care reached 100%. We suggest that these care strategies be applied to other units in the hospital.

並列關鍵字

isolation ward scabies care process

參考文獻


王登鶴、王震宇、陳淑廷、陳敏芳、王美麗(2016).疥瘡.感染控制雜誌,26(1),13-20。https://doi.org/ 10.6526/ICJ.2016.102
衛生福利部疾病管制署(2018,1月21日).疥瘡感染症.取自http://www.cdc.gov.tw/professional/ themanet.aspx?did=698&treeid=3cec8f1347d10061&nowtreeid=3cec8f1347d10061 https://doi.org/10.3390/tropicalmed3030098
Furuya, K., Nakalima, H., Sasaki, Y., Ishiko, A., & Urita, Y. (2016). A scabies outbreak in a diabetic and collagen disease ward: Management and prevention. Experimental and Therapeutic Medicine, 12(6), 3711-3715. https://doi.org/10.3892/etm.2016.3845
Leistner, R., Buchwald, D., Beyer, M., & Philipp, S. (2017). Scabies outbreak among healthcare workers in a German acute care hospital. Journal of Infection Prevention, 18(4), 189-192. https://doi.org/10.1177/ 1757177417690920
Peter, D., Meng, M., Kugler, C., & Mattner, F. (2018). Strategies to promote infection prevention and control in acute care hospitals with the help of infection control link nurses: A systematic literature review. American Journal of Infection Control, 46(2), 207-216. https://doi.org/10.1016/j.ajic.20 17.07.031

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