建構手術室病人安全照護模式－－以手術病人身份、手術部位、手術程序安全辨識為例

Establishment of a Safe Patient Care Model in Operation Room - Experiences from Patients Identification, Operation Site, Operation Procedure Verification

本研究目的包括： 建立手術室護理人員實施手術病人身份、手術部位、 手術程序辨識之護理標準； 設計手術室護理人員使用之「病人安全辨識查檢 表」，調查手術室醫護理人員使用「查檢表」滿一年後之滿意度；評值使用 「病人安全辨識查檢表」之成效。研究期間自2004年3 月1 日起至2005 年8 月31 日止，研究結果顯示：建立標準化查檢流程後，查檢流程總執行率由34.6%提 升至100% 。而“ 醫護人員滿意度調查' 回收率為80. 8 % （n=97 ） ，複迴歸分析 結果顯示主要影響醫護人員滿意度分數高低因素只有職級（ p=0.003 ， Adjust R2 =0.27 ）。查檢成效評估方面，查撿總錯誤率從0.10% 下降至0.008 % 。 本研究建立起諒院手術室病人安全辨識標準圭檢流程， 使手術室護理人 員工作上有據可循，且交接班手續明確化， 嚴格把關每個查核點， 以確保手 術病人安全，並將查檢結果提供外科醫護人員， 作為日後醫療品質改進的參 考。

The objectives of this project are: first, to establish the standards of procedures for operation room nurses to conduct patient identity, operation site, surgical procedure verification; second, to design a operation room patient safety verification check list; third, to investigate the satisfaction of operation room staffs after 1- year use of check list; fourth, to evaluate the efficacy in using this patient safety verification check list. The enrollment period spanned from March 1, 2004 to August 31, 2005. The patient safety verification rates increased from 34.6% to 100.0%. The return rate of staff satisfaction survey was 80.8% (n=97). Multiple regression result shows that occupation category is a significant predictor for staff satisfaction to the patient safety verification check list usage (p=0.003, Adjust R2 0.27). The total mistaken verification rates declined from 0.10% to 0.008%. The study proves that checklist can effectively establish the standard operation procedures for patient verification to improve patient safety, healthcare quality, and staff confidence in operation room.