提升血液透析工作人員對火災緊急應變能力之專案

A Project to Improve the Ability of Hemodialysis Staff to Respond to Fire Emergencies

背景：血液透析室一旦發生火災必須協助病人順利安全脫離透析機及迅速疏散病人，本單位位於高樓層，調查發現單位工作人員火災應變認知正確率只有57.9％，火災應變處理技能操作正確率只達57.4％，62.0％工作人員不清楚火災應變任務編組及任務內容，單位對病人行動能力定義不清造成工作人員依個人認知進行分類，缺乏預防火災緊急應變作業稽核制度及火災應變學習教材。目的：血液透析室工作人員對火災緊急應變認知與技能均提升至100％。解決方案：經專案小組擬定解決方案：（一）新增自衛消防編組至透析資訊系統；（二）製作火災緊急應變學習教材；（三）建立種子人員制度；（四）舉辦在職教育；（五）舉辦火災應變模擬演練；（六）執行稽核制度。結果：工作人員對火災緊急應變認知及技能操作正確性均提升至100％，且前後測達統計上顯著差異；持續落實解決方案，2019年6月至2020年5月工作人員火災緊急應變技能操作均維持100％。結論：桌上模擬、實際演練及技能操作稽核有助於提升工作人員火災緊急應變能力，建議各機構可製作桌上模擬道具，配合定期實地演練，讓工作人員熟練火災緊急應變，進而在事件發生時縮短應變時間。

Background & Problems: In case of fire in the hemodialysis room, it is necessary to help patients get away from dialysis machines smoothly and safely and evacuate the room rapidly. Our unit is located on a higher floor. An investigation showed that the accuracy rate for fire response awareness among the staffs in our unit was only 57.9%, while the accuracy rate of fire response skill operations was only 57.4%. Moreover, 62.0% of the staffs were not clear about the task grouping and task content of fire response. Confusion in our unit regarding the definition of patient mobility led to staffs classifying patients based on subjective perceptions and standards. Moreover, the unit also lacked an audit system for fire emergency operations and fire-response-related learning materials. Purpose: To improve staff knowledge and skills related to fire emergency response in the hemodialysis room to 100%. Resolution: The project team worked out solutions such as adding a self-defense fire-fighting group to the dialysis information system, producing fire emergency response learning materials, establishing a seed personnel system, organizing on-the-job education, organizing fire response simulation drills, and implementing an audit system. Result: The awareness of fire emergency response and the accuracy of skill operation among the staff were both improved to 100%, and there were statistically significant differences between the pre-test and post-test paired t-test results. Furthermore, consistent implementation of these resolution measures maintained the staff's fire emergency response skills at 100% between June 2019 and May 2020. Conclusion: Tabletop simulation, practice drills, and skill operation audits are effective tools for improving the ability of staff in the hemodialysis room to respond to fire emergencies. It is recommended that institutions produce tabletop simulation props and combine regular on-site drills to improve the readiness of their staffs to respond to fire emergencies, which will shorten the response time during incidents.