探討標準化流程提升健檢中心個案大腸鏡檢查腸道清潔度之效益分析

背景：大腸鏡檢查可早期診斷並治療大腸相關疾病。腸道末徹底清潔，影響大腸鏡檢查成效，造成病人須重新清潔腸道，增加醫療資源浪費，導致醫療服務品質滿意度下降。目的：探討標準化流程提升健檢中心個案大腸鏡檢查腸道清潔度之效益分析。方法：本研究採前瞻性設計，收集單一醫學中心，自2015年3月1日至2015年8月31日，立意取樣485位健檢中心個案為實驗組，402位門診個案為對照組，藉由大腸鏡檢查標準化流程進行護理指導，以腸道清潔度完整率來檢視其效益。採取SPSS18.0套裝軟體進行資料處理及統計分析，以卡方檢定及T檢定分析實驗組大腸鏡前、後大腸鏡檢查認知調查表、腸道清潔度完整率及個案滿意度，了解大腸鏡護理指導標準作業流程介入之臨床效益。結果：485位健檢中心個案，平均年齡60.1±10.8歲，285位（58.7%）男性，285位（58.7%）初次接受大腸鏡檢。經由大腸鏡檢查標準化流程進行護理指導，大腸鏡檢查認知率由66.3%提升至95.8%（p＜0.05），實驗組與對照組腸道清潔度完整率分別為95.5%及67.4%（p＜0.05），個案整體滿意度分別為91%及72%（p＜0.05）。結論：透過建構標準流程，可有效改善大腸鏡檢查服務品質，並大幅提升個案滿意度。

Background: Colonoscopy can diagnose and treat colorectal related disease early. Before receiving colonoscopy, the intestine should be cleaned completely, otherwise the effectiveness of colonoscopy will decrease, wasting of medical resources, and leading to lower quality of medical service and patients’ satisfaction.
Purpose: To analyse of using standard processes for upgrading patients’ intestinal cleanliness in health examination center.
Method: A prospective study enrolled 485 patients who were scheduled to undergo colonoscopy during March 2015 to August 2015 in health examination center and 402 outpatient patients for the control group at a single medical center. Using standardization processes for patients to upgrade patients’ intestinal cleanliness before receiving colonoscopy. Pearson’s chi-squared test and t-test were used to examine the effectiveness between these two groups.
Results: 485 patients used standardization processes. The mean age was 60.1±10.8 years, 285 (58.7%) were male and 285 (58.7%) were treated with colonoscopy first. The cognition rate of colonoscopy increased from 66.3% to 95.8% (P<0.05). The intact rate of intestine cleanliness was 95.5% and 67.4% (P<0.05) in the experimental group and the control group, while the overall satisfaction was 91% and 72% respectively (P<0.05).
Conclusion: To create standard processes can improve quality of colonoscopy and increase patients’ satisfaction.