提升兒科門診疫苗注射作業流程執行正確率

兒童預防接種是傳染病防治的重要策略。2019年3月連續發生3件疫苗異常事件，經衛生局勾稽查核，除需賠償疫苗金額外，也影響注射品質與安全。故2019年4月透過稽核、觀察、與訪談調查分析後，確認兒科門診疫苗注射作業流程執行正確率低的要因為：未確實查詢「醫療院所接種紀錄查詢子系統」、疫苗查詢系統便利性不足、醫囑系統建構不完整、疫苗接種標準作業缺乏細項說明。為將正確率從70%提升至100%，小組於2019年5月至2020年1月，製作疫苗注射流程圖、設置疫苗查詢工具書、醫囑系統增設常見疫苗阻擋機制、增設查詢系統連結於診間系統等策略。結果疫苗注射執行正確率達100%，建議持續將照護策略平行推展至院內其他需疫苗注射單位。

關鍵字

疫苗；預防接種；兒科門診

並列摘要

Child vaccination is an important strategy for the prevention and control of infectious diseases. Three consecutive vaccination incidents occurred in March 2019. After the inspection and verification by the Health Bureau, in addition to compensation for the vaccine, the injection quality and safety were also affected, so after conducting audits, observations and interviews in April 2019, it was confirmed that the low accuracy rate of the pediatric outpatient vaccination operation process was due to failure to check the ＂medical hospital vaccination record query subsystem＂ and insufficient convenience of the vaccine query system; the construction of the medical order system being incomplete; and the standard operation of vaccination lacking detailed description. In order to increase the accuracy rate from 70% to 100%, from May 2019 to January 2020, the team prepared vaccine injection flowcharts, set up vaccine query tool books, added common vaccine blocking mechanisms to the medical order system while adding a query system to connect to the clinic as well as a time system and other strategies. As a result, the correct rate of vaccination approached 100%. It is recommended that extending the care strategy to other units in the hospital that need vaccination be continued.

並列關鍵字

vaccine ； vaccination ； pediatric clinic

參考文獻

蘇韋如、林福田、張秀芳、陳淑芳、周玉民、楊靖慧、李秉穎(2019)．2018 疫苗政策重要變革．疫情報導，35(18)，262-271。https://doi.org/10.6524/EB.201909_35(18).0002

Bowling, A. M. (2018). Immunizations-nursing interventions to enhance vaccination rates. Journal of Pediatric Nursing, 42, 126-128. https://doi.org/10.1016/j.pedn.2018.06.009

尹慧菊(2013)．門診護理人員兒童預防接種知識、態度、行為之研究〔未出版之碩士論文〕．國立臺北護理健康大學。