放射科懷孕婦女X光診斷輻射防護安全作業流程改善

Improve Radiation Safety Processes of the Radiology Department

劉瓊珠(Chiung-Chu Liu) ； 蔡金完(Chin-Wan Tsai) ； 楊斐適(Fei-Shih Yang) ； 黃武達(Wu-Dar Huang) ； 林鼎裕(Tin-Yu Lin)

《台灣應用輻射與同位素雜誌》 8卷3期 (2012/09) Pp. 347-354

https://doi.org/10.29832/TJARI.201209.0006

摘要

通常婦女面對X光照射後，心中總是存有疑慮與顧忌，醫師應該使用強而有力的醫學研究證據為基礎來輔導受檢者避免誤解，本研究希望藉由懷孕婦女的X光放射診斷之輻射防護安全作業流程改善，提升懷孕婦女X光放射診斷輻射防護的安全性，降低懷孕婦女對輻射照相的憂慮，而提升放射醫療的服務品質。本研究收集65位適婚年齡婦女，進行女性接受醫療輻射作業問題詢問，並將問題統整針對問題進行統計，將作業流程經由技術主任一位、四位技術組長，進行流程改善，於改善作業流程後，對於改善後作業流程的疑慮降低程度進行女性接受醫療輻射作業疑慮之統計。在流程改善後，第一類、在無確定懷孕的情況下，女性接受醫療輻射會如何？由27次降低為1次，改善比率為92.6%。第二類、前幾天照了X光或CT，後來發現懷孕了，怎麼辦？由24次降低為1次，改善比率為95.8%。第三類、照完X光後，須隔多久才可以懷孕？由9次降低為0次，改善比率為100%。第四類為非本主題相關之問題？由5 次降低為0次，改善比率為100%。增設同意書，若欲受檢者來電告知確定懷孕給予留下基本資料由專人訪談，算出所承受輻射劑量並轉介婦產科繼續門診追蹤。若不確定懷孕者則建議下次月經十日內排檢；若與醫師討論無其他替代方案因病情所需受檢者則給予解釋後填寫同意書備案，並告知日後確定懷孕則來電諮詢。本研究的改善方式，可有效降低適婚年齡婦女對於接受醫療輻射作業之疑慮。

關鍵字

懷孕婦女 ； 適婚年齡婦女 ； 同意書 ； 醫療輻射作業

並列摘要

After being exposed to radiation, women are usually worried about side effects. For example, a woman who just notices that she is pregnant and underwent radiological examination recently may have questions that whether her fetus is affected by radiation or whether she should abort this fetus. When being encountered with such an anxious mother, a clinical practitioner should educate the mother on the basis of powerful and strongly evidence-based medical studies in order to correct misunderstanding. The current flowchart for childbearing women to undergo radiological examinations in our department is as the following. First, clinical doctors prescribe radiological examinations for patients. Second, patients sign in at our reception table with the examination sheets and then, if needed, replace their clothes with proper ones. Third, they go to the assigned examination rooms to undergo the radiological examinations by technicians. In this study, we initially selected 65 childbearing women randomly and each of them was asked whether she had any question about the examination and its influence. Then all the questions were collected and analyzed. Afterward, the flowchart was modified and another 65 childbearing women were selected randomly to join this study. We divided all the questions into four categories and compared the incidences of the question types before and after modification of the flowchart. Category 1: What happens when a woman with unsure pregnancy is exposed to radiation? (Before: 27, After: 1, Decrease rate: 92.6%) Category 2: How to do when a woman who just finds she is pregnant was exposed to radiation recently? (Before: 24, After: 1, Decrease rate: 95.8%) Category 3: After being exposed to radiation, how long does a woman should wait before deciding to have a baby? (Before: 9, After: 0, Decrease rate: 100%) Category 4: All other questions that are not related to the aim of this study. (Before: 5, After: 0, Decrease rate: 100%). In this study that could be decreased the misgivings and misunderstand for women.

並列關鍵字

Radiation ； Radiological Examination ； Childbearing Women ； Pregnancy