建立手術室器械計數流程標準管理及其成效評估

Standardization of Operation Room Instrument Management Protocols and a Performance Evaluation

蔡少雲(Shao-Yun Tsai) ； 陳雅惠(Ya-Hui Chen) ； 王拔群(Pa-Chun Wang) ； 吳家麗(Ka-La Wu) ； 胡寶雪(Pao-Hsueh Hu) ； 鍾佳伶(Chia-Ling Chung) ； 邱喬蘭(Chiao-Lan Chiu) ； 林志明(Chih-Ming Lin) ； 李銘家(Min-Jai Li)

《輔仁醫學期刊》 5卷4期 (2007/12) Pp. 181-188

摘要

Background and Objectives: With the aims of reducing human errors, improving patient safety, and containing hospital instrument costs, the objectives of this study were to standardize operation room instrument management protocols and to evaluate their performance. Methods: By establishing standard operation procedures for instrument counting, multiple instrument management protocols were implemented in February 2006. The completion rates of instrument counting and instrument loss rates were evaluated before and 3 months after initiation of the protocols. Chi-squared test and ANOVA were used investigate the efficacy of the quality improvement intervention. Results: The completion rates of instrument counting at 4 checkpoints for single surgeries improved from 81% to 95% (p＜0.05). The instrument loss rates were reduced from 0.69 to 0.32/surgery. The average cost incurred from instrument losses remained unchanged (p＞0.05), due to a limited follow-up duration. Conclusions: Standardization of operation procedures with regular audits is critical to the success of operating room instrument management. Continuous quality improvement efforts are being implemented with the aim of reducing instrument loss to zero; we believe this can further contain hospital instrument costs, enhance management competency, and improve operating room service quality and safety.

關鍵字

器械計數 ； 標準流程 ； 器械管理 ； 醫療品質

並列摘要

Background and Objectives: With the aims of reducing human errors, improving patient safety, and containing hospital instrument costs, the objectives of this study were to standardize operation room instrument management protocols and to evaluate their performance. Methods: By establishing standard operation procedures for instrument counting, multiple instrument management protocols were implemented in February 2006. The completion rates of instrument counting and instrument loss rates were evaluated before and 3 months after initiation of the protocols. Chi-squared test and ANOVA were used investigate the efficacy of the quality improvement intervention. Results: The completion rates of instrument counting at 4 checkpoints for single surgeries improved from 81% to 95% (p＜0.05). The instrument loss rates were reduced from 0.69 to 0.32/surgery. The average cost incurred from instrument losses remained unchanged (p＞0.05), due to a limited follow-up duration. Conclusions: Standardization of operation procedures with regular audits is critical to the success of operating room instrument management. Continuous quality improvement efforts are being implemented with the aim of reducing instrument loss to zero; we believe this can further contain hospital instrument costs, enhance management competency, and improve operating room service quality and safety.

並列關鍵字

instrument counting ； standard operation procedures