以「載具機器人」改善手術室護理人員執行術前器材包盤準備時間

Using Robotic Vehicle to Improve Equipment Transportation in Operation Room

手術室是一個著重安全及效率的部門，護理人員是最直接的照顧者，除手術過程中對病人的照護，需執行術前用物準備，而骨科器材包盤重且多，手部重複同一動作易造成肌肉骨骼不適，影響工作滿意度甚而造成人員離職，經專案發現人員執行器材包盤術前準備時間平均25分／台，對器材包盤運送滿意度僅64%，故引發專案小組探討動機並擬定改善，透過五項解決方案：引進「載具機器人」代替人力運送、規劃「載具機器人」路線與定位點、修訂器材包盤運送流程與舉辦教育訓練、檢討器材包盤重量，專案執行期為2017年2月至7月，其器材包盤準備時間由改善結果由25分鐘／台下降至7.5分鐘／台，器材包盤運送滿意度由64%提升至90%，達專案目的。藉由專案改善降低護理人員人工搬運之次數由4次減少至2次，且持續追蹤至2019年3月成效良好，器材包盤準備時間效果維持在5分鐘／台，讓護理專業回歸於臨床照護品質，進而確保病人照護品質與安全。

Operating room is a place focusing on safety and effectiveness. Nurses play an important role in providing direct care during operating process as well as preparing equipment for surgery. Due to great amount and repetitive of orthopedic equipment preparation, nurses suffer from muscular- skeleton discomfort and leading to low satisfaction and high turnover. The team found out that the average of equipment preparation time was 25 minutes per table and the satisfaction rate of transporting equipment for nurses was 64%. Therefore, the purpose of this program was to establish strategies to improve the quality of the service. Five methods were implemented from February to July 2017, including bringing in robotic vehicle to replace human transport, planning a route and fixed point for robotic vehicle, revising the process of transporting equipment, holding a in-house training program, and reviewing the weight of equipment and package. The results showed that the average equipment preparation time for each table decreased from 25 minutes to 7.5 minutes and the satisfaction rate of transporting equipment improved from 64% to 90%, reaching the pre-determined goals. Manual handling equipment transportation by nurses decreased from 4 times to 2 times. We followed this protocol up to March 2019 and the project remained effectiveness. The equipment preparation time further improved to 5 minutes per table. This program can be a reference for improving quality of care in operating room.