提升骨科關節鏡術前備物完整率

Improving the integrity of preoperative preparedness of orthopedic arthroscopy

手術前備物不完整容易導致手術時間延長，增加感染率的風險，也會造成醫療團隊間不信任感、降低工作效率。專案小組發現本院手術室人員常因對關節鏡備物不熟悉，以及備物不完整，導致手術醫師的抱怨，而延遲手術進行，影響工作氣氛、降低團隊士氣。經由現況調查發現關節鏡術前備物完整率為53.3%，主要導因有關節鏡備物不熟悉、醫師備物明細表未立即更新、儀器設備操作及設定不熟悉、耗材擺放位置多處，因而影響手術的時間。因此本專案的目的為藉由醫護合作，提升關節鏡術前備物完整率。透過在職教育及儀器系統教學、製作醫師備物檔案及明細表和明細圖片檔、製作儀器操作步驟手冊及接線標示、製作關節鏡便利包等等改善方案後，關節鏡術前備物完整率由53.3%提升為86.7%，顯示改善手術前備物完整，能增進手術醫護工作效率，以提升手術照護品質。 Incomplete preoperative preparation can lead to increased operative duration and risk of infection, and can also cause a breakdown in trust among the medical team and decreased work efficiency. An ad-hoc group found that the surgical staff in this hospital often experience lack of familiarity with arthroscopy preparation and incomplete preparation, resulting in complaints by the surgeon, and thereby postponing surgeries, affecting the work atmosphere, and decreasing team morale. A current status investigation found that the completion rate for pre-arthroscopy preparation was 53.3%. The main causes include lack of familiarity with arthroscopy preparation, lack of a detailed and updated preparation list, lack of familiarity with the operation and settings of devices and equipment, and placement of disposable items in multiple locations, thereby affecting the timing of surgery. Therefore, the aim of this project was to promote physician-nurse cooperation to improve the completion rate of pre-arthroscopy preparation. After introducing onthe-job education, instruction in use of devices and systems, creation of preparatory and detailed image files for physicians, and generation of device operating manuals and wiring labels, the completion rate for pre-arthroscopy preparation increased from 53.3% to 86.7%. This shows that improving preoperative preparation completion can increase surgical work efficiency and improve the quality of surgical care.