降低顱骨重建手術部位感染率之專案

Reduction of Incision Infection Rate Post-Skull Reconstruction Operation

葉慧敏(Hui-Min Yen) ； 邱怡貞(I-Chen Chiu) ； 楊惠琄(Hui-Chuan Yang) ； 陳家蘭(Chia-Lan Chen)

《志為護理-慈濟護理雜誌》 13卷3期 (2014/06) Pp. 82-93

摘要

神經外科術後照護病房顱骨重建手術部位感染率於2009年12月高達37.5%，引發進行此專案，目的為降低顱骨重建手術部位感染率。主要導因有：術前手術部位皮膚破損、預防性抗生素給予不確實、人員進出手術房間頻繁、外科刷手步驟正確性不佳、手術房間清潔完整性不佳、換藥車使用後消毒不確實、人員洗手步驟正確性及遵從性不佳。介入之解決方案包括：修訂毛髮準備及預防性抗生素給予規範、增設手術房門控制鈕、以乾式刷手法取代傳統刷手法、修訂清潔手術房間環境規範、改變換藥車配備內容、舉辦洗手教育等。專案實施後，感染率由37.5%降低至0%。期望將此專案推動措施全面應用於神經外科手術病人，以預防手術部位感染。

關鍵字

顱骨重建手術 ； 手術部位 ； 感染率

並列摘要

In the postsurgical ward of neurosurgery, surgical site infection rate after cranial reconstruction operation, in December 2009, was as high as 37.5%. The high infection rate prompted the birth of the project, which was aimed to find strategies to reduce the rate of infection at the incision site. Current problems include: preoperative skin damage, inconsistent administration of prophylactic antibiotics, frequent entering and exiting the operating room, suboptimal pre-operative scrubbing procedure, poor compliance of operating room cleaning, substandard post-operative disinfection, and incorrect or non-compliant hand-washing. The following interventions were implemented: revising rules on hair preparation and prophylactic antibiotics administration, adding extra control button for the operating room door, replacing the traditional scrubbing techniques with dry scrubbing, amending the post-operative surgical room cleaning procedures, changing the content of the dressing/equipment cart, and providing hand-washing education. After the project was implemented, the infection rate decreased from 37.5% to 0%. We hope that through this project, the new comprehensive measures can be widely applied to neurosurgical wards to decrease the rate of surgical site infection.

並列關鍵字

cranial reconstruction ； surgical site ； infection