護理人員執行化學藥物治療安全防護改善專案

A Project for Improving the Safety of Chemotherapy Administration in Nurses

本專案目的在提升護理人員執行化學藥物治療之安全，經現況分析發現護理人員執行化學藥物治療安全防護之認知正確率、執行正確率及化學藥物治療防護設備之正確率分別只有81.75％、52.59％及66.67％。主要導因為規範完整性不足、教育訓練不足、護理人員對化學藥物治療安全防護認知不足及病房防護之設備未妥善規劃。經由現況分析及文獻查證後，擬定解決方案：一、修訂「化學藥物治療給藥及用物處理標準作業規範」。二、舉辦「化學藥物治療安全防護」教育訓練。三、統一規劃病房化學藥物治療防護之設備，經以上執行措施後，護理人員執行化學藥物治療安全防護之認知正確率及執行正確率分別提升至93.65％及91.5％，病房化學藥物治療防護之設備正確率則提升至100％。本專案結果可提供護理人員執行化學藥物治療程序之安全處理，並建議醫療機構改善職場環境及設備的參考，藉此促進職場安全。

This project aimed to promote the safety of chemotherapy administration for nursing professionals. Analysis of the current administration of chemotherapy showed that safety-related problems of chemotherapy administration included three dimensions: knowledge of chemotherapy precautions, chemotherapy execution, and use of protective equipments. Statistical analysis of surveys on nurses showed an 81.75% accuracy on knowledge of chemotherapy precaution, 52.59% accuracy on chemotherapy execution, and 66.67% accuracy on use of protective equipments. These low rates of accuracy reflected insufficient standard guidelines and regimens as well as lack of in-service education and training. Some nurses did not wear protective gown because they felt it was time-consuming. The oncology ward would not function properly if insufficient protective equipments are insufficient. Based on the survey results and literature review, the procedures taken to improve safety of chemotherapy administration included (1) revising “standard guidelines for chemotherapy administration and handling”, (2) providing education on “standard guidelines for safety of chemotherapy”, and (3) centralizing the administration of protective equipments for chemotherapy on wards. After the above interventions, nurses scored higher on knowledge of chemotherapy precautions, accurate chemotherapy execution, and use of chemotherapy protective equipments (93.65%, 91.5%, and 100%, respectively). This project provides an example of improving working process and environment to ensure safety of chemotherapy administration in a hospital.