運用資訊系統提升無痛鏡檢病人準備作業之完整率

Using Information Systems to Enhance the Rate of Complete Preparation of Patients for an Endoscopic Examination

本專案旨運用資訊系統提升無痛鏡檢病人準備作業之完整率。在臨床上，病人時常詢問何時要做檢查，且鏡檢團隊花費許多時間，在聯繫鏡檢準備；甚至也發生護理師未追蹤完成麻醉諮詢，以及正確與下一班人員交班無痛鏡檢前準備進度，造成53.6%病人延遲受檢，經查核2014年無痛鏡檢病人準備作業完整率低77.6%，基於維護無痛鏡檢前作業品質而引發動機，經專案小組分析主要原因：一、醫療人員教育訓練不足；二、病人未維持檢查前禁食；三、鏡檢交班進度無依據；四、未制訂鏡檢交班規範及稽核。本專案提出解決方案：一、設計禁食提醒標語，標誌；二、規劃鏡檢排程系統；三、制訂無痛鏡檢交班規範；四、規劃跨團隊無痛鏡檢作業流程教育訓練；五、制訂無痛鏡檢前標準作業稽核，專案成效為：無痛鏡檢病人準備作業之完整率達100%，提升病人安全及增加工作效率。

This project aimed at utilizing information systems to enhance the rate of patients with complete preparation for an endoscopic examination. The endoscopic examination team requires a lot of time to ensure that everything is thoroughly prepared for an examination, and patients often inquire about when they will be able to take an examination due to the amount of preparation they need beforehand. There have been incidents where the nurse fails to complete anesthesia consultation or correctly hand over the preparation progress to the next shift, causing 53.6% of patients to have a delayed examination. In 2014, the rate of patients with complete preparation for a stress-free endoscopic examination was only 77.6%. Through analysis, the following causes of the low completion rate were identified: (1) insufficient training for the medical staff; (2) ineffective pre-examination fasting by the patient; (3) absence of a solid procedure for handovers; and (4) lack of regulations and auditing of handovers. To address these problems, the following solutions were proposed: (1) design slogans and posts to remind patients of fasting; (2) build an examination scheduling system; (3) set up principles for handovers; (4) arrange cross-team training on the procedure of stress -free endoscopic examinations; and (5) implement auditing of the preparation for a stress-free endoscopic examination. Through these procedures, the rate of patients with complete preparation for an endoscopic examination reached 100%, resulting in an improvement of both patient safety and work efficiency.