降低腫瘤科病房使用人工血管施行化療藥物外滲率之改善專案

A Project to Reduce the Risk of Chemotherapy Extravasation from Port-A Catheter in Oncology Ward

化療藥物外滲事件的發生涉及生命危險層面，故預防化療藥物外滲為首要病人安全目標。現況腫瘤科病房使用人工血管施打化療藥物外滲率為0.11％，專案小組分析造成化療藥物外滲率高原因：人工血管彎針注射完整性不足、敷料固定方式不一致、病人及家屬對於人工血管管路安全認知不足、缺乏完善化學治療管路安全維護指導工具，導致出現不當姿勢拉扯管路出現彎針移位異常。本專案執行期間為2016年06月01日至10月31日，透過專案改善方案：1.舉辦化療藥物外滲之醫學討論會、2.統一人工血管彎針敷料固定方法、3.製作化療貼心小語圖示卡。經方案實施後：人工血管施行化療藥物外滲率從0.11％降低為0％、人工血管注射正確率由98.0％提升至100％、病人對於化學治療管路安全照護認知由77.9％提升99.6％，達專案提升優質且安全之照護品質目的。

The occurrence of chemical drug extravasation events involves life-threatening aspects, so prevention of chemical drug extravasation is the primary patient safety goal. In our oncology ward, the extravasation rate is 0.11%, we organized a team and analyzed the reasons of the high extravasation rate. It included: insufficient integrity of Port-A needle injection, inconsistent dressing fixation method, lack of safety awareness of Port-A for patients and their families, and lack of sound chemical treatment pipeline safety maintenance guidance tools. This group has set up and implemented its operating procedures from June 1 to October 31, 2016. These findings led to a project aimed at improvements that included: 1. holding Chemotherapy Extravasation seminars, 2. Unified new Huber needle fixation method, 3. Designing patient education cards, After the implementations of the program: the exudation rate decreased from 0.11% to 0%, Port-A injection accuracy integrity increased from 98.0% to 100.0%, and the patient's awareness of safety care about chemotherapy increased from 77.9% to 99.0%. This project achieved its goal of improving the quality of patient care and safety of post-chemotherapy patients.