縮短顏面骨折導航手術前準備時間之專案

A Special Plan of Shortening the Preparation Time before the Facial Bone Fracture Navigating Operation

顱顏導航系統可提升術中骨折復位準確率，亦避免造成神經、血管等重要結構的損傷；於術中即時告知醫師重建是否到位及達到顏面對稱效果。現況發現導航手術準備時間平均43.7分鐘，造成原因：一、人員面：顏面骨折導航手術準備認知不足，材料用物準備、器械組裝及導航系統操作不熟悉。二、設備面：導航影像系統、器械材料無整合。三、制度面：無手術標準作業、在職教育訓練。改善方案：規劃導航系統定點定位、設置顏面骨折導航手術專用盒、制定導航手術準備作業標準、製作導航手術準備影音光碟、舉辦在職教育訓練。改善後手術準備時間從43.7分鐘降至12.7分鐘，導航手術準備認知正確率由55%提升至92%，達到專案目的。有效縮短手術整體時間，提升手術醫療照護之安全性。 The craniofacial navigating system can increase the accuracy of fracture replacement in the operationand avoid damaging important structures like nerve and blood vessels; moreover, it can show the effectsof replacement and the effect of facial symmetry in the operation. At present, the average preparationtime of the navigating operation was 43.7 minutes, and the reasons for the long preparation time areas follows: 1) Staff: the staff have inadequate knowledge of the preparation for the facial bone fracturenavigating operation and are unfamiliar with the preparation of materials, the equipment assembly andthe operation of the navigating system; 2) Equipment: the navigating image system and the equipment areincomplete; 3) System: the operation standards and in-service training are unavailable. The improvementmeasures were as follows: planned a designated place for placement of the navigating system; establisheda special box for the facial bone fracture navigating operation; created standards for the navigatingoperation; made education discs about the navigating operation; and offered in-service training. After theimprovement, the average preparation time reduced from 43.7 minutes to 12.7 minutes and the accuracyof the understanding of the preparation for the navigating operation rose from 55% to 92%, which met theobjective of this special plan. The achievement of this special plan can not only shorten the operation timebut also enhance the safety of medical care of the operation.