改善兒科護理人員大量輸液條碼給藥步驟執行正確率

A Project to Improve the Accuracy of Pediatric Nurses in Operating Intravenous Infusion Barcode Medication Administration System

背景：臨床運用條碼科技進行病人及藥品辨識，可提高給藥安全。本院自2012年5月開始推動大量點滴條碼系統給藥，兒科護理人員執行率僅61.5%，主要問題有：1.護理人員不熟悉BCMA(barcode medication administration )操作；2.習慣使用交班單；3.缺乏教育訓練；4.行動工作車過重；5.條碼不易刷取；6.切換電腦畫面耗時 7.資訊訊號易中斷；8.大量點滴配置流程不順；9.缺乏大量點滴條碼給藥作業稽核作業。目的：大量輸液條碼給藥步驟執行正確率從61.5%提升至100%。解決方案：本專案執行改善計畫包含：1.張貼使用條碼給藥標語並每日背誦標語；2.張貼條碼給藥步驟流程海報；3.舉辦BCMA操作在職教育；4.行動護理車減重方案；5.修改手圈規格；6.修訂兒科大量點滴配藥作業流程；7.大量輸液條碼給藥步驟執行正確率稽核。結果：大量點滴條碼給藥執行正確率從61.5%提升至100%。結論：本專案確實能提升護理師使用條碼系統執行大量點滴給藥之意願，大幅提升執行率，達到此次目標。

Background & Problem: We have been implementing barcode medication administration system (BCMA) in our hospital since May 2012. However, the initial rate of implementation was only 61.5%. The major obstacles were: (1) nurses were unfamiliar to BCMA; (2)nurses were accustomed to nursing Kardex; (3) lack of educational training; (4) e-nursing carts were heavy and difficult to maneuver; (5) the barcodes were difficult to scan; (6) switching between screens was time consuming; (7) network disconnect frequently; (8)intravenous infusion setup procedure problematic; (9) lacking inspection on BCMA operation. Purpose: Raise accuracy of BCMA operation from 61.5% to 100%. Resolusions: The following procedures were implemented: (1) post BCMA related slogans for daily recitals; (2) post barcode medication administration process posters; (3) hold in-service training on BCMA operation; (4) weight reduction on e-nursing carts; (5) modify patient ID wristband; (6) modify pediatric operating procedure of BCMA; (7) implement inspection on BCMA operation accuracy. Results: The accuracy of BCMA operation increased from 61.5% to 100%. Conclusion: The project successfully improved the willingness and accuracy of pediatric nurses in operating intravenous infusion BCMA.