頸動脈插入術備物不齊全之改善方案

A Program to Improve Preparation for Jugular Vein Catheterization

頸動脈插入術（Jugular Vein catheterization；JVC）是腎臟科病房常見技術之一。本專案目的是針對某病房因JVC備物不完整導致護理人員費時費力而進行改善，期望藉此專案能改善備物不完整。解決方法是透過組織流程改造（Organization reengineering）、 作業流程管理（business process management；BPM）運作來達成，在不增加成本及工作人員的負擔，應用單位一台空的工作車做改善，將現有的標準盤改為JVC工作車，符合經濟效益，並制定管理規範來遵循。自91年5月7日至5月22日止以觀察方法實施後，改善結果為JVC備物不完整比率由改善前的100﹪降至0﹪，標示盤不符合率由52.3﹪降至0﹪，顯示專案實施確實能發揮功能，直接能改善JVC備物不完整情況，縮短工作時間，間接使得治療流程更順暢。

Jugular vein catheterization (JVC) is one of the common skills used in Nephrology wards. The purpose of this study was to improve the preparation incompleteness of JVC and avoid the unnecessary wasting of nurse’s time caused by incomplete preparation of JVC. The problem was solved by conducting organization reengineering, and business process management. Without increasing the cost and work load of the operator, we used an empty cart to achieve this goal. We changed the standard plate to JVC cart, which was cost effective, and set up a standard operating procedure for the operators to follow. The observation period for this study was from May 7, 2002 to May 22, 2002. The results showed that both the JVC preparation incompleteness rate and unqualified standard plate rate decreased after the study (from 100% to 0% and 52.3% to 0%, respectively). In conclusion, our results show that this program is effective in improving preparation incompleteness and reducing work time, and may result in better treatment process.