某醫學中心改善手術部位標記率之研究

A Study on Promoting Marking Rate for Operation Field in a Medical Center

蔡慧珠(Hui-Chu Tsai) ； 蔡淑如(Shu-Ju Tsai) ； 李佩玲(Pei-Ling Lee)

《醫保研究雜誌》 2卷1期 (2006/03) Pp. 53-63

https://doi.org/10.29827/YBYJZZ.200603.0006

摘要

本研究旨在比較某醫學中心護理部改善措施能否有效提昇手術部位之標記率。研究樣本爲某醫學中心民國94年8月23日至9月9日間之外科手術病患共733人。評價採準實驗研究(Quasi-experimental design)之兩組（不同時間）後測設計；兩組樣本之選擇採立意分派，即民國94年8月23日至8月31日間手術病患爲對照組；民國94年9月1日至9月9日間手術病患爲實驗組；效果指標爲標記率。由於兩組間樣本之選擇採立意分派，故比較標記率時需考慮病患因素（包括：是否屬隱私部位、常規或急診刀、住院或門診等變項）及手術標記者部門別等干擾因素。介入措施自月日起，介入內容爲：(1)護理人員檢查病人手術部位後，立刻在『手術前後交班紀錄』單之「手術部位標示：□有□無」處勾選查驗結果；(2)凡未經醫師標示手術部位的病人，一律不送往手術室；(3)手術室等候區的病人未經醫師標示手術部位者，一律不送入手術房間。結果顯示實驗組標記率顯著高於對照組（97%比67%）；控制干擾因素後實驗組之標記率仍顯著高於對照組，故本次改善措施能有效提高標記率。新措施後仍有3%未做標記，建議需進一步追蹤改善，期能使標記率達100%。

關鍵字

手術部位標記

並列摘要

This study aims to evaluate the marking rate of operation field for a promotion program in a medical center. The study included 773 person times of surgical patients. A quasi-experimental design was implemented to evaluate the marking rates between two groups; Patients receiving operations from Aug. 23, 2005 to Aug. 31, 2005 was regarded as the control group and those from Sep. 1 to Sep. 9 as the intervention group. Since purposive assignment was used, factors within patients (such as operation sites of privacy, emergency of the operations and patients from admission or outpatient services) and theses specific to different clinical services have to be taken into consideration. The promotion program started from Sep. 1, consists of (1). Nursing staff ticking the yes or no box in a check list immediately after checking on the operation field; (2). No allowance of transfers for patients without marking from wards to waiting area of the operation theater； (3). No allowance of transfers for outpatients without marking from waiting area to the operation room. The result showed that there was a significant higher rate of marking in the intervention group than in the control (97.1% vs. 66.5%). After the confounding factors was controlled, the rate in the intervention group was still significantly higher than the control (P＜0.05). Therefore, we concluded that the promotion program is effective on improving the rate of operation field marking. However, the unmarked rate was 3% left. We recommend promoting the intervention further until a 100% marking rate is achieved.

並列關鍵字

operation field marking