- 期刊
提升周邊血液幹細胞收集正確率
Improving the Accuracy of Hematopoietic Stem Cells Collection
摘要
台灣每年平均有493人接受周邊血液幹細胞移植，當幹細胞發生汙染可能產生併發症或影響移植成功率，甚至導致病人死亡。本病房專科主任於2019年5月反應周邊血液幹細胞汙染率高達50%，引發專案小組改善動機。經現況分析發現：作業標準管理不佳、教育訓練不足及工作流程中斷，導致護理師執行周邊血液幹細胞收集正確率0%。擬訂措施包含：建置專科性作業標準管理辦法、修訂作業標準、規劃在職教育、設置收集用物包、制定收集步驟流程圖、建立擬真訓練計畫。專案改善後護理師執行周邊血液幹細胞收集正確率由0%提升至100%，知能正確率也從82.7%提升至100%，幹細胞汙染率亦由50%下降至0% 顯示專案措施可有效提升周邊血液幹細胞收集正確率。
並列摘要
An average of 493 patients receive peripheral stem cell transplantation per year in Taiwan. Contaminated stem cell infusion not only reduces treatment survival rate but also leads to morality. In May 2019, the director of our oncology specialist department reported that the contamination rate of peripheral stem cells was as high as 50%, which triggered the motivation of the task force to improve. Hence, a general analysis was conducted which found that: lack of standard protocol, insufficient training programs, and interference during the stem cell harvest and transfusion process resulted in a 0% correct rate of peripheral stem cell collection by nurses. A project was launched with the goals to build the professional standard protocol, the clinicals instruction, training programs, the convenient harvest package, a harvest flow chart, and a real-time stem cell harvest training program. After the implementation of the project, the accuracy rate of the stem cell harvest has increased from 0% to 100%. The harvest knowledge has also increased from 82.7% to 100%. The contamination rate of stem cells has also decreased from 50% to 0%. The result showed strong evidence of increasing the accuracy rate of stem cell collection in this project.