- 期刊
改善置入型中心靜脈導管相關血流感染之專案
The Improving Project of Bloodstream Infections Relate to Port-A Catheters
摘要
癌症病人一般須裝置皮下置入型中心靜脈導管以利化療治療、輸注治療或營養補充，但易因相關血流感染而影響療程及預後。本單位2016年1～3季Port－A血流感染密度平均為（千分之2.8），第四季上升至（千分之4.6）。經現況分析發現主要原因為：消毒方式及範圍不正確、護理師未落實洗手、注射過程角度不孰悉、缺乏Port－A注射及照護標準及未實施教育訓練。依原因研擬對策方案有：製作創意模具結合舉辦在職教育、製作洗手提示卡並定期稽核、修訂Port－A注射及照護標準，經對策實施後Port－A相關血流感染密度由（千分之4.6）降至（千分之2.6），達專案目的，利用創意模具提供人員針對注射過程進行練習及標準化作業，降低Port－A相關血流感染，也提升病人安全之護理，且制訂之照護標準流程可作為臨床人員之參考。
並列摘要
In general, patients who suffer from cancer need to install subcutaneous central venous catheters for chemotherapy, infusion therapy or nutritional supplements. But it is susceptible to bloodstream infection and have an effect on treatment and prognosis. The average density of Port-A bloodstream infections in the first three quarters of 2016 was (2.8 per mille), and it rosed to (4.6 per mille) in the fourth quarter. Analyzing the main reasons were: sterilization methods and area were incorrect, the nurses did not implement hand washing correctly, unfamiliar angle of the injection process, lack of knowledge about Port-A injection procedure and care standard, and education training was not implemented. According to the reasons, the countermeasures are as follows: produce creative molds and combine it with on-the-job education, making hand-washing cue card, and inspect and revise Port-A injection procedure and standard periodically. After the implementation of the countermeasures, the bloodstream infections density of Port-A has been reduced from (4.6 per mille) to (2.6 per mille), the result achieved to purpose of the project. Using creative molds provide staffs to practice and standardizing the injection process can decrease bloodstream infections which associated with Port-A Catheters, improve patient's safety care and set up a standard care process to be used as a reference for clinical staffs.