組織再造－－改善病房協助換藥效率

Reengineering to Improve the Efficiency of Assisting Change Dressings in Plastic Wards

本專案是以組織再造之理念與變革方法，針對整形外科病房協助換藥效率不佳進行換藥作業的改造。其目的在重組換藥作業人力安排，改進換藥車，以達到節省人力、時間，而增加換藥效率。於87年1月至88年5月依榮泰生（民80）組織變革五個步驟，由病房品管圈行政組負責推行，重新設計改良換藥車，增加敷料用品配備，重組換藥人力，刪除換藥班，改由全責護士協助換藥，護理佐理員（簡稱護佐）負責敷料間之物料控管。專案結果顯示，協助換藥作業能有效率完成，一年約節省42個工作天，工作人員對革新後換藥車之配備量、用品種類及取用物料之滿意度均達84%以上；換藥班護士回歸病患護理工作增加了病患的照顧人力，且能提供病患整體的照顧；此外，每年約減少病房27,010元感染性廢棄物處理費，也減輕醫院處理感染性廢棄物負擔。在全球皆促導組織改造來增加競爭力的時刻，本專案謹提出筆者的經驗與護理界同仁分享。

This program adopts the Long.'s reengineering concept to improve the efficiency of change dressing procedure in plasty surgery wards. The purpose of this study aims for increasing the efficiency of change dressing by saving manpower and time through reorganizing change dressing staff and improving the change dressing cart. From January 1998 to May 1999, according to the five steps of Long Teisan's Revolution, the ware Quality Cycle Administration group redesigned the change dressing cart, increased dressing equipment, reorganized the change dressing labor by shifting change dressing nurse to primary nurses to cover change dressing, and the dressing goods were controlled by nursing assistants. The result of this program revealed that we may save 42 workdays per year. There was more than 84% satisfaction rate over the reorganizing change dressing cart and dressing materials and equipment. The shift of change dressing nurse to primary nurse adds to patient care labor and also changes the functional care model to primary care to promote patient total care. Besides, 27,010 dollars was reduced per year for infectious garbage disposal. At the time of the improved competitive ability by advocating reengineering globally, this project was presented to share our experience with all nursing colleagues.