運用5S降低血液透析室環境菌落數不合格率

5S Reduces Environmental Microorganism Colonies in the Hemodialysis Room

為降低血液透析室環境菌落數不合格率，本專案以生物冷光反應法採檢環境菌落數不 合格率為47.6%，分析原因為醫療儀器無固定置放位置且未確實清潔、清潔工具無區分 使用、清潔工具汙穢潮濕、漂白水溶液配製不正確、無清潔人員工作規範、清潔人力不 足、病人單位無淨空無法進行清潔。藉由推行5S整理、整頓、清掃、清潔和素養原則， 修訂醫療儀器設備清潔工作規範、制定清潔工作規範、製作提醒標語、修改清潔工具使 用方式、執行班間淨空等方法，落實環境清潔工作，使菌落數不合格率降至7.9%，養成 人員落實及監測環境清潔的習慣，以維護病人安全，提昇照護品質。（志為護理，2020; 19:5, 84-96 ）

This study aimed to reduce the number of environmental microorganism colonies in the hemodialysis room. A biological fluorescence reaction assay revealed 47.6% of unqualified colonies in the room. Our analysis identified the following reasons for this finding: cleaning tools are dirty and indiscriminately used, medical instruments once cleaned are not returned to their positions, the bleaching solution is not properly prepared, the cleaning personnel is insufficient and are not working properly, and the patient unit is not cleared. By implementing the principles of 5S phases Sorting, Straightening, Systematic cleaning, standardize and Sustain, the medical equipment cleaning work specifications, the development of cleaning work specifications, the production of reminder slogans, the modification of the use of cleaning tools, the implementation of clearances between class and class, etc., and the implementation of environmental cleaning work, a reduction in the the colony failure rate from 47.6% to 7.9% was achieved. Thus, developing habits to implement and monitor a clean environment can maintain patient safety and improve quality of care. (Tzu Chi Nursing Journal, 2020; 19:5, 84-96)