提昇門診結核病完治率之改善專案

Plans to Increase Cure Rates for Tuberculosis Outpatients

本專案主旨在改善門診結核病病人完治率偏低之情況，經現況調查發現問題主要是：門診護理人員本身對結核病療程及藥物作用不清楚，缺乏標準化之衛教資料，衛教地點不合宜及未建立追蹤機制，致使本院結核病人對疾病認知得分率為45.4%，而結核病病人之完治率僅69.0%，低於縣內完治率85.0%。經本方案透過以下解決辦法：（1）規劃結核病之在職教育訓練。（2）擬訂個案管理模式。（3）制定結核病患者護理指導標準。（4）規劃合宜衛教地點。（5）建立患者標準化就醫管理流程模式，訂定結核病患者後續追蹤機制。結果病人對結核疾病認知提昇至94.3%，結核病病人完治率達89.2%。

The aim of this project was to improve the low rate of successful treatment for tuberculosis in one hospital outpatient department. Based on our findings, the causes for the high failure rate of tuberculosis treatment at our outpatient clinic were (1) inability to provide thorough patient education, consisting of (2) lack of a standard patient education program, and (3) inadequate facilities for providing complete patient-to-patient, as well as (4) incomplete patient monitoring and follow-up systems. These inadequacies account for our limited success at treating tuberculosis patients, as low as 69.0%. We therefore outlined and implemented a series of measures intended to promote successful cures, including: (1) equipping nurses with a patient education program, (2) establishing a case management model, (3) standardizing nursing care strategies, (4) arranging adequate facilities for patient education, and (5) setting up improved patient monitoring and follow-up systems. After these measures were implemented, patients knowledge increased to 94.3%, and the success rate for tuberculosis treatment rose to 89.2%.