降低門診病人使用胰島素筆型注射器之針扎發生率

Reducing the Incidence of Needlestick Injuries Due to Insulin Pen Injectors among Self-Users in the Outpatient Clinic Setting

背景：隨著嚴謹控制血糖的需要，糖尿病患者居家執行胰島素注射治療的增加，胰島素針頭針扎意外已由醫療端，延伸到病人注射技巧問題上，用過後針頭不回套及正確操作流程，才能免除病人受針扎的威脅。於2012年2月至4月隨機問卷調查80位糖尿病門診病人，於居家使用胰島素筆型注射器時意外針扎發生率高達70%，分析原因發現：單位無作業標準、未舉辦在職教育、無輔助衛教單張、居家病人缺乏取下針頭工具及技能等問題，導致病人針扎發生率高。目的：專案旨在降低門診病人使用胰島素筆型注射器之針扎發生率，以達到病人安全的目的。解決方案：經專案小組制定作業標準、舉辦在職教育、製作衛教單張、創新設計針頭收集瓶、教導居家病人針頭正確處理方法等。結果：門診病人使用胰島素筆型注射器之針扎發生率由70%降低至2.6%。結論：此專案有效降低病人針扎率，期望能將專案成效推展至相關單位，以落實病人安全之防護。

Background & Problem: The rising number of people practicing insulin self-injection at home has led to increasing numbers of needlestick injuries due to inadequate self-injection skills among these patients. To reduce needlestick injuries at home, patients should not recap needles and should adopt proper needle disposal practices. A random survey of 80 outpatients currently using insulin pen injectors at home conducted between February and April 2012 found that 70% self-reported suffering needlestick incidents. Data analysis indicated the principal causes of these incidents were the lack of standard operating procedures, the absence of educational training, the shortage of educational instruction sheets for patients, and the inadequate skills and tools available to patients for disposing of needles safely at home. Purpose: The aim of this project was to decrease the needlestick incidence rate for outpatients that use insulin pen injectors in order to increase overall patient safety. Resolution: The project team established a pen injector standard operation procedure (SOP), conducted an educational training program, developed nursing instruction sheets for patients, designed and distributed needle disposal containers to patients, and taught patients the correct techniques for the disposing of needles at home. Result: The needlestick incidence rate decreased from 70% pretest to 2.6% following implementation of the abovementioned measures. Conclusion: This project effectively reduced the needlestick rate attributable to insulin pen injectors. The authors hope that other departments will adopt this approach in order to improve patient safety.