縮短血液透析室病人火災緊急應變撒退時間之改善專案

Improvement Project on Timely Fire Evacuation for Patients under Hemodialysis

因醫院高樓化、電氣配管複雜及病人受限於透析管路連接著機器易導致逃生困難，單位於2020年8月進行火災撤退演練，撤退時間為28分鐘17秒，高於消防署規定的21分鐘。故成立專案小組進行改善，分析確立問題為沒有參與過火災緊急應變撤退實際演練、撤退逃生路線標示不清、衛教指導後未確實評值病人的了解程度、相關衛教指導工具不足。執行期自2020年9月1日至2021年1月31日，為期5個月，依計劃期、執行期及評值期三階段進行，介入措施包含舉辦火災緊急應變撤退實際演練、製作撤退動線夜光引導標示、規範火災緊急應變撤退認知及技能稽核標準、製作火災緊急應變撤退小卡、衛教單張、教學影片及透析管路分離作業流程。專案實施後，病人對火災緊急應變撤退的認知由改善前的42.0%提升至改善後的88.4%，而撤退技能由改善前的38.9%提升至改善後的88.0%。撤退時間亦由28分鐘17秒縮短為19分鐘50秒。使病人在火災發生時，更有助於確保自身生命安全。

 

Difficulty in evaluation is considered due to the high-rise building of the hospital, the complicated electrical piping, and the fact that patients during hemodialysis are limited by the dialysis machines. A fire drill was conducted in August 2020, and the evacuation time was 28 minutes and 17 seconds. It is higher than the 21 minutes stipulated by the fire department. Therefore, a task force was formed to make improvements. After analyzation, we found several problems to be solved. First of all, patients had not participated in actual fire evacuation drill. Second, the evacuation routes were not clearly marked. Third, patients’ understanding was not adequately evaluated after our health education guidance. Fourth, the relevant health education guidance tools were insufficient. The implementation period is from September 1, 2020 to January 31, 2021, for a period of 5 months, in three stages: planning period, implementation period and evaluation period. Therefore, improvement measures was conducted, including holding actual fire drill with emergency evacuation, making luminous evacuation sign for escape routes, regulating auditing standards of cognitions and skills for evacuation, making emergency evacuation photocards, health education guidance leaflets and videos, and establishing operationg procedures of dialysis equipment separation. After the implementation of the project, the cognition improvement of patients about the emergency evacuation of fire was from 42.0% to 88.4%, and the skills of evacuation was from 38.9% to 88.0%. Furthermore, the evacuation time shortened from 28 minutes and 17 seconds to 19 minutes and 50 seconds. Eventually, it is more helpful for patients to ensure their own safety in the event of a fire.