兒科護理人員對醫材處置漏登之改善方案

A Plan to Improve Failure to Record Medical Material by Pediatric Nurses

本專案目的為改善護理人員登錄醫材處置的方法，將原本改善前之醫材處置漏登率20.4%降低。89年4月始進行改善方案、製定醫材處置配套單作登錄、建立登錄範本、宣導成本概念及專人審查等措施。改善後之醫材處置漏登率於7月是5.7%；醫材處置漏登率於改善後效果維持情形9月是2.1%，11月是0.8%；目標達成率於7月是95%、9月是119%、11月是127%；品質改善率於7月是72%、9月是90%、11月是96%。改善後護理人員在醫材處置登錄時間方面，明顯縮短；醫材漏登金額也減少。建議護理主管日後繼續檢查護理人員在醫材處置登錄情形，且可對相關人員探查，如醫師之醫囑完整性、輸帳人員輸入之正確性；以及新進人員的在職教育中，加入成本效益的課程，以達良好的帳務管理。

The purposes of this project were to improve the methods used by nurses to record the use or disposal of medical materials, and to reduce the rate of failure to record medical materials, which before improvement was 20.4% in May 2000. This project was begun in April 2000. The processes carried out were: 1. Designing the improvement plan; 2. Preparing a medical material record sheet package; 3. Writing a guide book for recording medical materials; 4. Instructing nurses in the concept of cost awareness; and 5. Checking medical material records. As a result, the rate of failure to record medical materials was reduced to 5.7% in July 2000, 2.1% in September 2000 and 0.8% in November 2000. The rate of target achievement was 95% in July, 119% in September and 127% in November. The rate of quality improvement was 72% in July, 90% in September and 96% in November. Time spent recording medical materials was decreased significantly after the plan was implemented. Inaccuracy was reduced too. The authors suggest that in the interest of good financial management, nursing managers should follow up such a program by continuing to monitor the recording of medical materials by nurses, the completeness of doctors instructions, and the correctness of data entry by data entry staff, and by educating new staff about cost efficiency.