降低精神科病房病人持有危險物品發生率之專案

A Project of Reducing the Existence of Hazards in a Psychiatric Ward

病人的安全維護和意外事件的預防，在病室的管理上是一件很重要的工作，本病房品管小組利用品管圈的方法，針對病房病人持有危險物品的問題做分析，找出了四個主要的原因：1.新入院之病人及家屬對「危險物品使用之注意事項」不清楚；2.日間病房病友未能了解危險物品之危險性及不遵守規定；3.病況穩定之病人，借用危險物品後未歸還；4.工作人員未確實執行病人、家屬入院之安全檢查。茲運用品質管理循環P、D、C、A(Plan, Do, Check, Action)之概念架構進行改善，採用四大對策：(1)修訂住院須知；(2)訂定日間病房危險物品管理規則；(3)制定危險物品借用及歸還辦法；(4)修訂並確實執行安全檢查常規及查核制度。實施後使病人持有危險物品的發生率由原來每月的1.03%降低為0.44%。經由此次改善方案的進行，不僅提供病患一個安全無虞的環境外，更因此而促進了病房人員的團結向心力，這是此次品管圈的另一大收穫。Keeping safety of and preventing accidents from patients are important issues to ward management. The ward team of quality control circle (QCC) was adopted as a method to scrutinize the hazard in this study. The situation analysis showed four major origins as follows: (1)Not doing health education clearly to family members and new daycare patients about “Regulations of hazards in a psychiatric ward”; (2)Day-care patients didn’t recognize the hazards thus were unable to follow the regulations; (3)Not sending back the hazards from the stable patients who borrowed it; (4)Not exactly executing security standards among staff to scrutinize the hazards toward family members and patients when admitting. The authors used PDCA quality cycle to solve these problems. Four strategies used were as follows: 1.To modify the patients’ admission sheet of need-to-know, 2.To make regulations for hazardous item usage in the daycare, 3.To set rules for scrutinizing the hazards, 4.To ascertain the security standards of hazards among staff. After these implementations, the results showed existence rate of the hazard that patient carried reduced from 1.03% to 0.44% per month. Not only did the project provide a safe environment for patients, but also improve the working cooperation further.