提升急救車喉頭鏡葉高層次消毒完成率之專案

Promoting the Completion Rate for High-level Sterilization of Laryngoscope Blades in First-aid Carts

本專案旨在提升喉頭鏡葉高層次消毒完成率。經調查發現，本院備有急救車之11個單位，對於使用後之喉頭鏡葉，只有兩個單位完成消毒步驟。經分析後發現問題為：1.未制定喉頭鏡葉消毒標準；2.缺乏高層次消毒專業教育；3.針對高層次消毒缺乏走動管理機制；4.急救車缺乏簡單圖示消毒步驟；5.院內網頁及感控手冊對於喉頭鏡葉高層次消毒資料建置不完善。專案小組參考文獻及他院之經驗，以制定喉頭鏡葉消毒標準作業流程、規劃高層次消毒在職教育、建立高層次消毒走動管理之查核機制、急救車消毒步驟之設置、感控專區新增喉頭鏡葉高層次消毒影片介紹，來改善喉頭鏡葉消毒的問題，結果：喉頭鏡葉高層次消毒完成率由18.1%提升至90.9%，可減少病患因侵入性醫療措施造成交互感染。

The aim of this project was to improve the completion rate for high-level sterilization of laryngoscope blades in first-aid carts. Eleven stations are equipped with a first-aid cart in our hospital. On investigation, it was found that only two stations had completed the sterilization steps needed for using a laryngoscope blade. After analysis, the following areas were found to be problematic. Firstly, there was no standard procedure for laryngoscope blade sterilization. Secondly, there was a lack of professional education in the area of high-level sterilization. Thirdly, there was no management process for controlling high-level sterilization. Fourthly, a simple illustration of the sterilizing steps needed for the blade was not available in the first-aid cart. Finally, the internal hospital website and the infection manual contained only incomplete information on the procedure for high-level sterilization. Initially, the project team established a standard procedure for laryngoscope blade sterilization. This was followed by on-the-job education about high-level sterilization of laryngoscope blades. In addition, a management check scheme to assess high-level sterilization was developed. Finally, a first-aid cart sterilization procedure was created together with a video describing high-level sterilization of laryngoscope blades. The latter was placed on the infection control website to help to reduce any problems associated with laryngoscope blade sterilization. The complete rate for high-level sterilization of laryngoscope blades was improved from 18.1 % before the interventions to 90.9% after the interventions. These changes, it is hoped, will reduce the possibility of cross infection when an invasive medical technique such as laryngoscopy is carried out.