運用PDA系統降低急診檢體退件率之改善方案

An Improvement Project to Reduce Specimen Errors with the Use of the PDA Barcode System

檢體採集為急診護理工作中重要常規之一，檢體退件會延誤病人診斷與治療，增加醫療成本浪費及護理工作量。2014年1-6月因人為疏失的送檢流程不正確遭檢驗科退件共計89件，故本專案以實際工作觀察法進行問題確認。經檢視臨床現況及查閱文獻後，評估以導入PDA11條碼系統化檢體送檢為主，進而修改採集檢體送檢流程，宣導期間製作檢體採集送檢流程海報示意圖、隨行卡、安排在職教育訓練及護理品質監測。專案實施後，檢體送檢流程被退件件數由每月平均14-15件降為2件，採集檢體送檢流程正確率由63.2%提升為98.9%。本單位透過此專案之執行不僅能降低檢體退件率，同時提升病人安全醫療照護品質。

Specimen collection and delivery is one of the important routine tasks for nurses in the emergency department. Turndowns of specimens cause delay of patient diagnosis and treatment and increase healthcare expenses and nurse workloads. There were 89 specimen turndown occurrences because of inaccurate specimen delivery secondary to human factors from January to June, 2014. This project used real time on-site observation to identify the key problem. After examination of the clinical situation and review of the literature, the taskforce team assessed the use of the PDA barcode system for specimen delivery, modified the process of the specimen collection and delivery, produced posters and pocket-sized cards for promotion of the use of the PDA barcode system, arranged training in-service schedule, and further monitored for quality of practice. After the implementation of the project, specimen turndown occurrences dropped from 14-15 to two per month. The accurate rate of specimen collection and delivery increased from 63.2% to 98.9%. This project not only lowered the specimen turndown rate, but also promoted patient safety and quality of care.