運用品質改善活動提升門診醫師洗手遵從率－以台北某地區教學醫院為例

Using Quality Improvement Activities to Enhance Physicians' Compliance Rates of Hand-Washing in an Ambulatory Setting - A case Study of a Community Teaching Hospital in Taiwan

吳宛庭(Wan-Hui Wu) ； 康春梅(Chun-Mei Kang) ； 張馨予(Hsin-Yu Chang) ； 陳嵐茵(Lan-Yin Chen) ； 蔡玫娘(Mei-Niang Tsai) ； 林淑菁(Shu-Ching Lin) ； 王金香(Chin-Hsiang Wang) ； 馮文侃(Wen-Kan Feng) ； 簡志誠(Chih-Cheng Chien) ； 王拔群(Pa-Chun Wang)

《醫療品質》 4卷2期 (2011/09) Pp. 1-12

https://doi.org/10.29759/HQ.201109.0001

摘要

世界衛生組織在2005年的手部衛生指引中指出，乾淨的照護就是安全的照護，強調洗手對於預防感染的重要性，而醫師是醫院內最常直接接觸病人族群之一，因此希望透過提升門診醫師洗手遵從率的改善活動，降低感染、提升醫療品質進而促進病人安全。本研究以單盲觀察門診醫師洗手遵從率調查，在未進行介入措施前門診醫師洗手遵手率約為16.9％。為了提升醫師洗手遵從率，進行員工教育訓練、海報及洗手標語宣傳、增加洗手設備可近性、制定「乾洗手液洗手作業流程」及獎懲辦法等等。介入方案實施後，洗手遵從率增加至65.3％，醫師門診洗手遵從率明顯提升，進一步保障民眾就醫的安全性及醫療品質，對病人安全有很大的貢獻。

關鍵字

手部衛生 ； 洗手遵從率 ； 品質改善活動

並列摘要

Clear care is safer care-hand hygiene has been listed as a priority in providing clean care in the 2005 WHO guideline. Since physicians often in direct physical contact with patients; to improve healthcare quality and patient safety, in this study we introduce quality improvement efforts with aims to enhance physicians' hand-washing rates and to reduce infection rates.Before the quality improvement intervention, the single-blind observation method revealed the physician hand-washing compliance rate was 16.9%.To improve the recognition and attitude of physicians, we implemented series of improvement campaigns, including employee education, reminding posters and propaganda, increase numbers of hand washing facilities, establish hand-washing standard of procedures, and enforcement of reward-punishment regulations.After intervention, the physician hand washing compliance rate has remarkably increased to 65.3%. We believe the improvement of hand-washing compliance can effectively transform to the healthcare quality and patient safety improvement in our hospital.

並列關鍵字

hand hygiene ； Compliance rates of hand washing ； quality improvement activity