縮短眼科門診護理人員辨識使用散瞳劑病人的時間

Shortening of Nursing StaffWork Hours to Identify the Outpatients Who Used Mydriotics at Ophthalmology Clinic

為減少使用散瞳劑病人候診時間過長之困擾，並使作業過程確保安全與順暢，縮短護理人員辨識使用散瞳劑病人花費時間已成就醫流程改善重點。專案旨在縮短護理人員辨識點散瞳病人至瞳孔散大時間，小組於2010年11月15日至30日對3位護理人員進行調查，發現人員辨識病人後第一次點散瞳劑直到瞳孔放大的時間平均長達46.6分鐘，以80/20原則找出原因為：多位病人同時散瞳、未製訂辨識工具及未設立散瞳病人候診專區等三項。藉由使用A5記錄表病歷放置盒、製作辨識掛牌、設立散瞳病人候診專區，結果縮短護理人員辨識使用散瞳劑病人至瞳孔放大時間，由46.6分鐘縮短至29.3分鐘，讓眼科病人就醫流程更順暢且安全，提昇醫療服務滿意度並達高效率、高品質之目標。Reducing patient waiting time and lessening staff time to identify the outpatients who used Mydriotics at Ophthalmology Clinic are major process improvement tasks. This project aimed to reduce nursing staff time in identifying the outpatients who used Mydriotics. We surveyed three nurses between 15th and 30th of November 2010. We found that the average time from the initial applying Mydriotics to the pupils fully dilated was about 46.6 minutes. We applied the 80/20 principle to analyze the cause of delayed time: more than one outpatient using the Mydriotics at the same time, not providing the tool to identify outpatients who used Mydriotics, and not setting up the pupil dilation section at the clinic waiting area. Putting an A5 size sheet on the home page of close-chart, making identification cards, and setting the specific area for the patients waiting for pupil dilation could shorten time for nursing staff to identify the outpatients from 46.6 minutes to 29.3 minutes. We demonstrated a process improvement in pupil dilation procedures and reached our goal of providing high quality and efficient care at Ophthalmology clinics.