提升護理人員執行肝動脈釔90放射性栓塞術照護防護之正確性

目的：肝動脈釔90放射性栓塞術藉由高輻射消滅腫瘤，護理人員照護過程易暴露於輻射風險。現況發現原因1.政策面：缺乏執行標準作業及相關教育訓練；2.設備面：無適用的測量動線工具、病室擺設定點困難、未提供病人衛教手冊；3.人員面：對輻射防護認知低、未曾接受輻防安全教育及擔心輻射傷害。本專案是透過重新檢視單位安全相關作業程序，整合資源建立安全標準化查檢流程。方法：制定肝動脈釔90放射性栓塞術標準作業、增設物料箱、建置病人術後指導手冊、舉辦教育訓練並制定標準參閱本及監測機制。結果：護理人員照護認知由48.3%提升至96.5%，照護作業正確性由47.8%提升至97.3%。結論：透過強化照護人員的輻射防護照護知識及提供標準化工具，促使護理人員重視自身的健康與安全，營造安全的醫療環境。

關鍵字

釔90 ；輻射風險；防護安全；護理照護

並列摘要

Purposes: Yttrium-90 microsphere trans-arterial radioembolizationvia the hepatic artery destroys tumors via high dose rate brachytherapy so that nurses risk being exposed to radiation. Reasons for the Current Condition were as follows: 1. On the policy aspect: the lack of execution of standard operation and the relevant education & training, and no regular audits; 2. On the equipment aspect: no suitable measuring paths tools, difficulty in furnishing positioning at wards, failure to offer the standard procedure on the nursing instruction for nurses as well as the patient education pamphlets; 3. On the personnel aspect: low cognition of care, no radiation protection safety education, the worries about radiation injury as well as unclear shift handover. Methods: Draw standard procedure of Yttrium-90 microsphere transarterialradioembolization via hepatic artery, set up cabinet of material, issue the postoperative instructions manual for patients, arrange educational training, and set the standard reference textbook as well as the surveillance mechanism. Results: The results showed that the cognition of care of nurses increased from 48.3% to 96.5% and the accuracy of nursing care increased from 47.8 % to 97.3%. Conclusions: This improvement project can help the nurses to value their own health and safety through strengthening healthcare knowledge of radiation protection and provide appropriate tools to create a safe medical environment and good quality.

並列關鍵字

Yttrium-90 ； radiation ； protection safety ； Nursing care

參考文獻

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提升護理人員執行肝動脈釔90放射性栓塞術照護防護之正確性

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