改善消化系內視鏡再處理流程之品質與成效

Improvement of the Quality and Effectiveness of Digestive Endoscopy

內視鏡再處理流程 （Endoscope reprocessing） 是指內視鏡清潔與消毒的再處理流程，若處理不當容易引發嚴重的醫療照護相關染，是目前全世界重要的醫療安全議題之一。某醫學中心消化系內視鏡暨超音波診斷治療中心自 2013 年 1月 1 日起至 2015 年 9 月 30 日針對消化系內視鏡以管路沖洗法、拭子擦拭法進行定期監測，採檢件數共 178 件，其中有 11 件呈陽性。調查發現主要原因為技術人員未落實執行內視鏡清洗消毒標準作業流程、教育訓練機制不完善及設備不足。經由修定內視鏡再處理標準作業流程，進行技術人員內視鏡清潔與消毒再處理標準步驟的再教育，2016 年每季內視鏡例行細菌培養報告皆為陰性。由結果可知，適當改善內視鏡再處理的管理機制，可有效降低相關的感染事件，維護病人的安全。

Endoscope reprocessing is an important process of cleaning, disinfecting, andsterilizing gastrointestinal endoscopes. It is a critical safety issue worldwide, asinappropriate reprocessing leads to an outbreak of nosocomial infection.From January 2013 to September 2015, a total of 178 microbial cultures wereexamined in a Gastrointestinal Endoscopic Diagnosis and Treatment Center of amedical center. Of them, 11 specimens were found to have a positive microbialreaction, including Pseudomonas spp. (n = 5, 41.7%). After completing the revisedstandard operating procedures of endoscopic reprocessing and staff re-education,the incidence of microbial infection was no longer reported in the quarter of 2016.Therefore, improvement in the management, based on patient’s safety, is required inorder to reduce gastrointestinal endoscope-related infections.