經由植入式皮下注射器注射化學藥物滲漏的改善方案

The Improvement of Preventing Chemotherapy Extravasation from Subcutaneous Infusion Port

本專案旨在使經由植入式皮下注射器(簡稱：Port-A)注射化學藥物年滲漏率由4.39﹪降為0。小組分析93年五位案例滲漏原因並擬定改善策略：1.教育護理人員辨識滲漏的警訊及設立Port-A注射化學藥物流程。2.改良現有的Port-A固定方法。3.設立「經由Port-A注射化學藥物照護查核表」。4.制定「經由Port-A注射化學藥物期間應注意事項」。5.增加不同尺寸的彎針。專案實施後，滲漏件數為0件，達到設定之目標。應用科學驗證的方式讓護理人員了解執行植入式皮下注射器化學治療時手部移動角度與注射部位敷料間的相關性，讓護理人員可以正確的辨識滲漏警訊，照顧化學藥物治療病患時更有安全感及信心，成功防堵經植入式皮下注射器注射化學藥物所造成的滲漏。

The aim of this study was to decline extravasculation rate of chemotherapeutic drugs from 4.39% to 0%. The team members directed the previous 5 cases of extravasculation. They found the problems and made the action plan, including: 1.Educating the people about being alert to the condition of extravasculation and build the technological processes, 2. Improving current way of fixing, 3.Seting up the checklist, 4.Seting up the education sheet, 5. Increasing variable size needles. As a result there were no more extravasculation episodes, thus reaching the aim. Nursing staff could understand the signs of extravasculation correctly and have stronger confidence while taking the patients through chemotherapy. Then there can be success in preventing extravasculation of the chemotherapeutic agent.We adapted a scientific demonstration to let the nursing staff understand the relation between angle of ambulant hands and the dressing with chemotherapy via subcutaneous infusion port. This helps to accomplish the integrative nursing care during chemotherapy.