提升血液透析室生物醫療廢棄物之分類正確率方案

醫療廢棄物若處理不當，不僅讓人員暴露在高風險環境中，亦會造成環境的危害，並提高處理成本。本單位醫療廢棄物分類稽核異常率高達20.7%，引發專案小組改善動機，目的在提升生物醫療廢棄物之分類正確率。本專案執行期間自2019年1月1日至12月31日，根據現況分析發現問題：醫護人員、病人與陪病者對廢棄物分類認知不足、護理指導工具不足、廢棄物桶標示不清、工作車的分類設備不完善、缺乏考核獎懲制度。經由：安排在職教育訓練、製作標準分類提醒圖表、製作衛教手冊及海報、拍攝宣導短片、製作分類清楚標示圖卡、增加行動護理車分類設備和設計可分類完善收針車、訂定完整稽核制度及獎懲辦法。結果分類行為正確率由57.9%提高至93.3%；分類稽核異常率由26.4%降為5.1%；醫護人員認知由70分提高至100分；民眾認知由52分提高至85分，達到專案目標，有效提高醫療環境的安全及照護品質。

關鍵字

血液透析；生物醫療廢棄物；正確率

並列摘要

If medical waste is not handled properly, not only staff will expose in high-risk environments but also increasing the cost of processing environmental hazards. The abnormal rate of Classification Audit in our department is up to 20.7%. The purpose of this project is to improve the classification accuracy rate of biomedical waste. The execution period is from January 1st, 2019 to December 31st, 2019. We analyzed and found out the problems as followed. First, insufficient knowledge of medical waste classifications among medical personnel, patients and accompanying of patients. Second, the unit's medical waste bins were not clearly classified due to lacking of guidance tools. Third, shortage of trolley carts with poor sorting system. Fourth, award system is not completed. These can be improved by providing on-the-job training. Also providing reminder charts, health manual instructions and poster of accurate classification. A promotional video, table charts or cards of accurate classification with pictures and descriptions will help. More trolley carts with functional categories and design to have a better recycle of mobile infectious needle recovery trolleys. Last but not least, a complete award system with audit, rewards and penalty is also a great help. By doing so, the accuracy of Classification project will be improved to 93.3% from 57.9%. The abnormal rate will drop to 5.1% from 26.4%. Medical personnel awareness increased to 100% from 70%. The public awareness will also increase to 85% from 52%. It will effectively improve the safety of the medical environment and the quality of care.

並列關鍵字

hemodialysis ； biomedical waste classification ； accuracy

參考文獻

沈明怡、張鈞竹、李夢英、林瑞香（2017）．降低加護單位生物醫療廢棄物產量．護理雜誌，64（5），81-90。https://doi.org/10.6224/JN.000071

郭惠貞、蔡宜蒨、陸俐君、曹英（2016）．兒科病房生物醫療廢棄物減量之改善成效．源遠護理，10（2），39-47。https://doi.org/10.6530/YYN/2016.3.3

張境晏、吳麗敏、葉毓婷、宋建美（2015）．提升某院血液透析室護理人員醫療廢棄物分類之正確率．臺灣腎臟護理學會雜誌，14（3），47-60。https://doi.org/10.3966/172674042015091403004

Khan, B. A., Cheng, L., Khan, A. A., & Ahmed, H. (2019). Healthcare waste management in Asian developing countries: A mini review. Waste Management and Research, 37(9), 863-875. https://doi.org/10.1177/0734242X19857470

Pandey, A., Ahuja, S., Madan, M., & Asthana, A. K. (2016). Bio-medical waste managment in a tertiary care hospital: An Overview. Journal of clinical and diagnostic research, 10(11), DC01-DC03. https://doi.org/10.7860/JCDR/2016/22595.8822

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