初次罹患乳癌之求醫歷程

Process of Seeking Treatment for Newly Diagnosed Breast Cancer

本專案目的降低兒科病童週邊靜脈輸液導管阻塞率，單位週邊靜脈輸液導管阻塞率7.2%。經現況分析問題為：缺乏提醒時間的工具、找尋主責護理師處理點滴的時間過久、靜脈輸液導管護理之標準作業內容不完善、缺乏兒童靜脈輸液導管之照顧相關衛教及無適合靜脈輸液導管留置病童穿脫的病服等問題。於2012年5月提出對策為使用靜脈點滴時間提醒卡、計時器及無線對講機、製作病童靜脈衣、製作衛教海報、修訂照護標準作業、舉辦在職教育及執行稽核等對策，有效降低週邊靜脈輸液導管阻塞率，從7.2%下降至3.4%，達成專案目標。建議臨床導管照護應持續護理人員在職教育訓練及教導家屬及早觀察導管阻塞現象的能力。

The purpose of this project was to reduce the occlusion rate of peripheral intravenous catheters in a pediatric ward. In the investigated unit there was an initial peripheral intravenous catheter occlusion rate of 7.2%. An analysis of the collected variables revealed that the following factors contributed to increased occlusion rate: the lack of a timer to remind staff, an ineffective method of informing staff to manage intravenous administration, inappropriate standard operation procedure (SOP) for staff and patient education, and unsuitable clothing for children with intravenous infusion catheters. The use of intravenous reminder cards, timers, walkie-talkies, suitable children's clothing for intravenous catheters, health education posters, revised standard of procedure, in-service education as well as audits were implemented. As a result, the peripheral intravenous occlusion rate decreased from 7.2% to 3.4%, achieving the goal of project to improve the quality of catheter care.