提昇護理人員執行化學治療作業之正確率

Improving Nursing Staff Accuracy in Administering Chemotherapy

背景：化學治療藥物具細胞毒性，故注意用藥安全及預防護理人員給藥疏失是重要的課題。本組於2007年1月13日至2月3日間，以「化學治療作業檢查表」針對血液腫瘤科病房進行現況資料分析，發現護理人員執行化學治療作業正確率偏低，僅68.4%，主要原因有五：1.化學治療標準作業規範不完整；2.缺乏化學治療作業品質管理辦法與評核機制；3.護理人員對化學治療作業認知不足；4.洗手設備及防護用具取用不便；5.護理人員遺忘巡視注射部位。目的：本專案旨在提昇護理人員執行化學治療作業之正確率，及提升護理人員對化學治療作業的認知。解決方案：1.修訂化學治療標準作業規範；2.制定化學治療作業品質管理監控計劃；3.舉辦化學治療訓練課程；4.增加工作車洗手設備與防護用具；5.增設定時提醒工具。結果：護理人員執行化學治療作業正確率提昇至96.7%；護理人員對化學治療作業的認知得分由77.5分提昇至89.2分。結論：此專案確實可改善護理人員執行化學治療作業之正確率及提升照護品質。

Background: As most anticancer drugs are cytotoxic, their safe and error-free application is important. We analyzed data from the hematology-oncology ward chemotherapy checklist dated January 13th through February 3rd, 2007 and found accuracy rates for chemotherapy drug usage as low as 68.4%. Possible causes identified for this poor result include incomplete chemotherapy standards protocols, lack of chemotherapy quality control, and insufficient chemotherapy knowledge amongst nursing staff.Purpose: This project aimed to improve the accuracy of nursing staff in administering chemotherapy and to raise nursing staff knowledge regarding chemotherapy.Resolution: Our strategies for improvement included completing a chemotherapy standards protocol, establishing a chemotherapy quality-control monitoring system, augmenting chemotherapy training and adding appropriate equipment and staff reminders.Result: After strategies were implemented, accuracy in chemotherapy administration rose to 96.7%. Related knowledge amongst nursing staff also improved from an initial 77.5% to 89.2%.Conclusion: Implementing the recommended measures achieved a significant improvement in the accuracy and quality of chemotherapy administered by nursing personnel.