使用即時監控系統管理急診電腦斷層檢查之可行性與效果

The Feasibility and Effect of Using Real-time Monitoring System to Manage Emergency Computed Tomography

蘇懿徽(Yi-Hui Su) ； 蔡明昇(Ming-Sheng Cai) ； 張哲誠(Zhe-Cheng Zhang) ； 李明杰(Ming-Jie Li) ； 盧信宇(Xin-Yu Lu)

《中華放射線技術學雜誌》 44卷2期 (2020/06) Pp. 83-89

摘要

欲進行電腦斷層檢查之病人，在執行檢查前往往要進行多項評估與前準備。在急診，這些資訊皆是由急診護理人員透過電話告知放射科人員，期間有時會造成資料的錯誤或不完整。為改善此現象而建立“即時監控系統”，從急診醫師開立電腦斷層檢查單起開始監控病人資料（開單時間、病歷號、姓名、病床號、檢查項目、對比劑施打、腎功能指數），且一旦病人訊息有變化（變更床位、腎功能指數…），此系統也隨之更新。本研究透過對此程式之使用者的滿意度調查（分數為1～5分，最滿意5分，最不滿意1分）來評估可行性，並透過放射科取得病人資料錯誤或不完整之事件來評估其效益。在即時監控系統建置前滿意度平均值2.5分，建置後4.7（p＜0.05）；而病人資料之錯誤與不完整事件由10.9%到建置後下降到0.9%，（p＜0.05）。顯示臨床放射師對此系統的使用接受度是相當高的，且降低了病人資料錯誤與遺失的發生機率。

關鍵字

即時監控資訊系統 ； 電腦斷層 ； 急診

並列摘要

Computed tomography is extensively used in the clinical setting, providing valuable diagnostic information for physicians. Prior to the scan, patients are expected to go through numerous assessments as well as preparations. In the emergency setting, often radiographers receive procedure orders from ER nurses via telephone which may potentially causes errors in patient's information due to miscommunication. The purpose of this study is to tackle errors that may occur during the process and ensure procedures perform efficiently. The establishment of ＂real-time monitoring system＂ is to monitor the process detailing patient's data (time of procedure ordered, procedure with or without contrast medium, accession number of the exam, location of the patient, and renal function.) In addition, the system will automatically update any changes. This study assessed the feasibility of the system through questionnaires from radiographers, with a grading scale from 1 to 5, where 5 is excellent, and 1 represents dissatisfied. Incorrect or incomplete patient data also played a crucial part in the assessment. The average satisfaction level before the establishment of real-time monitoring system was 2.5 points. The overall satisfaction level significantly rose to 4.7 points after the introduction of real-time monitoring system. Also, incomplete patient data and errors are reduced from 10.9% to 0.9% after the establishment of the system. Furthermore, square test (P value ＜ 0.05) showed that there is high acceptance of the system by radiographers, and there is reduction in incidences of patient data errors and loss.

並列關鍵字

real-time monitoring system ； computed tomography ； emergency