運用PDCA循環提升長期照護機構住民用餐滿意度

Using a PDCA Cycle to Improve Residents' Dietary Satisfaction at a Long-term Care Facility

目的：化學治療在癌症治療中扮演著相當重要的角色。依據個案醫院化療藥局統計資料顯示2012年腫瘤科化療處方錯誤率高達0.73%，因此，專案小組藉由醫品圈活動進行醫療品質改善。方法：執行專案期間為2011年1月至2012年4月，具體改善措施包括：修改作業標準、修改原有醫囑系統、增購化療醫囑系統、建立醫囑開立複核機制、建立醫囑套餐、辦理教育訓練並納入新人教育訓練計劃、建立E-learning學習管道、擴充醫囑組套等。結果：化學治療處方異常率由原來0.7%明顯降為0.1%，而在化療醫囑系統開立化療醫囑的平均時間也自改善前的39分鐘降至18分鐘，達專案設定目標。結論：本專案跨醫療、護理、藥劑、資訊等不同領域人員共同組成醫品圈，利用資訊化控管整個作業流程，更能有效率的提昇病人用藥安全，降低工作人員負荷。

Objective: Chemotherapy has a major role in cancer treatment. According to the chemotherapy pharmacy statistics at our hospital, the abnormal chemotherapy prescription error rate was 0.73% (17/2,318) in 2012. Therefore, this case group sought to improve medication use with a quality control circle (QCC). Methods: Concrete measures for improvement included altering operation standards, altering the order entry system, purchasing a chemotherapy order entry system, establishing a prescription review mechanism, creating physician order templates, holding educational training and incorporating a new recruit educational training program, establishing an e-learning channel, and expanding physician order sets between January 2011 and April 2012. Results: The abnormal chemotherapy prescription error rate decreased from 0.7% to 0.1%, and the average time spent writing a chemotherapy prescription on the chemotherapy prescription system was reduced from 39 minutes to 18 minutes, reaching the goal of this study. Conclusion: This project created a QCC encompassing medical treatment, nursing, pharmaceuticals, and information, and improved the abnormal chemotherapy prescription error rate through teamwork. Digitization was used to control the entire work process and can effectively raise medication safety and reduce worker burden.