子宮頸抹片異常個案回診率低改善專案

Improving the Follow-up Rate of Abnormal Cervical Smear

林幸娟(Hsing-Chuan Lin) ； 莊玉仙(Yu-Hsien Chuang) ； 陳秀月(Hsiu-Yueh Chen)

《高雄護理雜誌》 27卷1期 (2010/05) Pp. 13-23

https://doi.org/10.6692/KJN-2010-27-1-2

摘要

本專案旨在改善子宮頸抹片異常個案回診率，本院2006年7至8月異常個案平均回診率42.2%，經電訪資料分析發現主要問題：個案對疾病知識不足、缺乏回診動機、對回診資訊不了解、報告單設計不良、醫護人員未適時衛教、缺乏追蹤流程且無專人作電訪關懷。故針對原因進行改善方案，經制訂子宮頸抹片篩檢衛教單張、擬訂子宮頸抹片篩檢作業追蹤流程及將電訪關懷納入工作常規、修訂子宮頸抹片篩檢報告通知單內容、衛生教育宣導及護理人員於個案看診時提供衛教單說明等措施。在團隊合作下，回診率由42.2%提昇到60.0%，經電訪關懷後，總回診率達72.7%，高於目標值65%；期望透過專案的推動，能提升婦女對自我健康管理的重視，早期發現疾病早期治療，以減少延誤治療的時機。

關鍵字

子宮癌 ； 子宮頸抹片 ； 異常個案 ； 回診率

並列摘要

The aim of this project was to improve the follow-up rate of abnormal cervical smear results in our hospital. Based on the data of July and August in 2006, the average rate of follow-up was 42.2%, which was relatively low. After phone interviews with patients, we found that the main problems included: patients' lack of knowledge of illness, patients having no motivation for follow-up, patients' lack of sufficient information for follow-up, poorly designed enquiry form, no timely health education, no tracking protocol, and no dedicated personnel to perform a regular telephone contact with patients. To improve the follow-up rate for a better disease control, our solutions included: redesigning the health education document for cervical examination; setting up a cervical smear test standard procedure and a tracking protocol; performing a regular telephone contact with patients; revising the notification letter of Pap smear results; propagating health education information; and providing correct health education in clinical sessions. After the enforcement, the data showed an increased rate of follow-up to 60%, better than the original 42.2%. Further phone interview (s) promoted the follow-up rate to 72.7%, which was higher than 65% target rate. This project promoted the emphasis of women’s self-healthy management, quality assurance in prevention of cervical Cancer, and the avoidance of the chance of delayed treatment.

並列關鍵字

cervical cancer ； cervical smear ； abnormal pap smear ； follow-up rate