急診門禁管理品質改善專案

Access Control Mechanism in Emergency Departments : A Quality Improvement Project

目的：提升並分析急診門禁管理。

方法：南部某醫學中心急診部於2020年初因應冠狀病毒疾病(COVID-19)疫情發展，執行門禁管控品質提升計畫。該計畫包含開發急診病人陪伴證，管制進出自動刷卡門，資訊化管理駐警手機陪伴證稽查等。2020年3月16日至2020年3月26日進行網路問卷調查，以評量品質提升成效。

結果：總共回收161份問卷，其中32(19.9%)是急診醫師，64(39.7%) 護理師，34(21.1%)警衛，31(19.3%) 是病人及家屬。總體滿意度為93.5%，在環境安全，隱私，及感染控制的滿意度最高。門禁管控對於減少臨床及護理作業干擾及職場暴力也受到肯定。然而，門禁可能造成探病不便，病人及家屬的情緒壓力增高。

結論：急診門禁管制不僅對環境與感染控制極為重要，也助於醫療與護理臨床作業。

 

Purpose : To evaluate and improve the access control of emergency departments.

Materials and methods : In early 2020, we conducted a project to establish an access control mechanism for inhibiting the spread of coronavirus disease (COVID-19) in the emergency department of a tertiary teaching hospital in Tainan, Taiwan. The project included the use of a pass for accompanying individuals, the use of an auto sensor for door control, and the information management of security guards by using mobile applications. A web-based questionnaire survey was conducted between March 16, 2020, and March 26, 2020, to evaluate the outcome of the project.

Results : We collected 161 survey responses, of which 32 (19.9%), 64 (39.7%), 34 (21.1%), and 31 (19.3%) were from emergency physicians, nurses, security guards, and patients and their families, respectively. The overall satisfaction rate was 93.5%, and most participants agreed that access control is necessary for environmental security, privacy, and infection control. Access control is also beneficial for minimizing care interruption and workplace violence. However, access control may increase emotional distress and inconvenience for patients’ families while visiting patients.

Conclusion : Access control of emergency departments is crucial for environmental and infection control as well as for effective medical and nursing practices.