以精實管理的技巧降低精神科日照中心給藥時間

忙碌的護理工作中，所有技術流程均須審慎評估才能執行，其中給藥流程攸關病人安全及就醫品質，本院於2016年6月4日開始使用資訊給藥系統，又因本單位為精神科日間照護中心，發藥天數、次數與一般病房不同，在現行無法配合資訊給藥系統運作下，造成護理師核發藥物時間冗長，平均每次高達144分鐘，且每月大量印製給藥治療紀錄單，亦不符合全國無紙化的醫療政策。為了降低給藥作業時間並提升病人就醫品質，專案小組於2018年7月到2019年4月，以精實管理的技巧，計算本精神科日照中心給藥中的價值時間，學習簡化流程的手法、設計日照中心資訊給藥系統，變更護理師藥物衛教模式、更改衛教過程的動線，實施後平均給藥作業時間由原來144分鐘降為88分鐘，共縮短56分鐘，並將價值時間發展翻轉教育，用來提升病人的就醫品質，可顯示運用精實管理於醫療上處置上的肯定。

關鍵字

精實管理；給藥時間

並列摘要

Regarding detailed nursing operation, every technical process must be carefully evaluated before implementing. Among those processes, the drug administration is vitally important for being related to patient safety and medical quality. Our hospital started to use the system of drug administration on June 4^(th), 2016. However, the Psychiatric Day Care Center still has difficulty to comply with it because of a variety of wards. The variety causes massive waste of unnecessary time in drug administration, 144 minutes more on average, and also against the national paperless medical policy by producing plenty of medication record sheets monthly. To reduce the drug administration time and improve the quality, from July 2018 to April 2019, the task force applied lean management skill on the following methods, including 1. calculating the value time of the Psychiatric Day Care Center drug administration and learning how to simplify the procedure, 2. designing the system of Day Care Center drug administration, and 3. improving the model and traffic flow of drug health education, which reduced the average administration time from 144 to 88 minutes. In other words, 56 minutes were saved in total, thereby having an additional time to develop flipped education to improve the patient's medical quality. The result shows that applying lean management is conducive to medical treatments.

並列關鍵字

lean management ； the time to medication administration

參考文獻

Al-Balushi, M. M., & Al-Mandhari, Z. (2018). Implementing lean management techniques at a radiation oncology department. Sultan Qaboos University Medical Journal, 18(3), 362-366. doi:10.18295/squmj.2018.18.03.016

尤琇慧、張麗銀、彭素貞（2018）・精實思想管理以傷口照護流程為例・領導護理，19（1），13-21。