某區域醫院COVID-19 專責病房醫療人員執行個人防護評核之經驗

Evaluation of Personal Protective Equipment Conformance in Healthcare Workers Working in a COVID-19 Ward of a Regional Hospital

全球新冠肺炎(coronavirus disease 2019, COVID-19)疫情肆虐下，醫療人員擔心照顧病人的同時，自己也有染疫風險，並傳染給家人。因此本研究將78名即將進入專責病房之醫療人員進行1.以螢光乳劑監測手部衛生執行正確度。2.N95口罩密合度定性測試。3.以螢光乳劑監測防護裝備穿脫正確度，結果發現未使用手部衛生七步驟洗手方式螢光乳劑殘留比率達54%，而依循此步驟洗手，雙手平均螢光乳劑殘留比率為4.2%。78名醫療人員執行N95口罩密合度測試有8人未通過，經調整選擇合適之N95口罩，再次測試皆為通過；防護衣脫除由上至下由內向外捲、脫外層防水隔離衣、脫防水性連身型防護衣為脫除步驟錯誤率前三項；醫療人員脫除防護裝備螢光乳劑染污前三項部位：頭（頭髮）(24.4%)，小腿及腳並列第二(19.2%)，膝蓋第三(16.7%)；95%以上的受訓人員皆同意經過訓練有助於提高照顧確診病人時的信心與安心，也減少擔心受感染的心理壓力。個人防護裝備穿脫演練在醫院中列為每年必備的教育課程，但醫療人員面臨突然而來的新興傳染性疾病，仍是會有許多的未知恐懼，因此運用客觀的螢光乳劑工具在手部衛生執行及個人防護裝備穿脫流程的考核，可以讓醫療人員往後可以更加留意，並且減緩照顧病人時的心理壓力。

During the coronavirus disease (COVID-19) pandemic, healthcare workers are concerned about the risk of infection and further transmission to their families. We evaluated hand hygiene and personal protective equipment appropriateness of 78 healthcare workers who had prepared to work in the designated quarantine ward using fluorescence cream and N95 respirator fit test. The results showed the following results. (1) Fluorescence cream residual rates were 54% for the incorrect hand hygiene procedure and 4.2% for the standard hand hygiene procedure. (2) Eight trainees failed to pass the N95 respirator fit test and then passed after choosing the appropriate N95 respirator. (3) Doffing the gown from up to bottom and the inside to outside, doffing the outer apron, and contamination while opening the zipper were the most common errors while doffing personal protective equipment. (4) The most common contaminated locations were the head and hair (24.4%), legs and feet (19.2%), and knees (16.7%). (5) More than 95% of the trainees agreed that the simulation course enhanced their confidence in caring for patients with COVID-19 and reduce the stress regarding infectiousness. A personal protective equipment simulation test is conducted at the hospital every year. However, healthcare workers still fear emerging infectious diseases. Applying fluorescence cream on personal protective equipment during the simulation course can immediately demonstrate the residual fluorescence while using incorrect hand hygiene or personal protective equipment donning and doffing procedures. Thus, it can increase the healthcare workers’awareness and reduce their anxiety while caring for patients with COVID-19.