降低健康管理中心消化道內視鏡檢驗不合格率

Reducing Abnormal Culture Rates of Digestive Endoscopy in a Health Management Center

背景：消化道內視鏡是現代醫學中用以預防、診斷或和治療許多消化系統疾病不可或缺的重要工具之一。消化道內視鏡細菌培養檢測常用於再消毒品質監測的方法之一。目的：本專案旨在降低消化道內視鏡細菌培養陽性率，提升內視鏡消毒的品質。解決方案：本專案自2018年2月1日至2019年2月28日間，調查消化道內視鏡清潔現狀，提出改善措施包括:修訂內視鏡消毒作業規範、制定消毒劑監測更換規範、設計清洗消毒技術訓練計畫、製作清洗消毒學習教材、購置符合內視鏡高度儲存櫃。結果：專案執行後內視鏡檢驗不合格率由5.8%降低至0%。結論：內視鏡微生物培養是評估標準化消毒處理程序之有效性的評估方法，建議未來應每年檢視最新文獻與感染管制原則，進行作業標準的修訂與技術演練，並詳實保存相關紀錄，定期檢討改善，以提供更優質的服務品質。

Background & Problems: Endoscopic evaluation plays an indispensable role in medical treatments designed to prevent, diagnose, and cure gastrointestinal disease. Surveillance culture monitoring may be useful in monitoring the outcome of reprocessing. Purpose: In this project, microbiologic surveillance cultures were employed to improve the quality of flexible endoscope disinfection. Resolution: This project, implemented from February 1st, 2018 to February 28th, 2019, used several approaches to improve the positive culture rate. We redesigned and implemented the standard operating procedures for endoscope reprocessing, established an in-service training course, provided education materials on reprocessing, and installed a storage cabinet that custom-built to accommodate the endoscope. Results: The positive culture rate was reduced from 5.8% to 0%. Conclusion: Endoscopy culturing is a useful method to assess the effectiveness of standard reprocessing procedures. The development of guidelines and skill practices should follow current, evidence-based practice and infection prevention principles, and related documents should be organized. We suggest regularly deploying quality-improvement techniques to improve performance and service delivery.