運用跨團隊合作降低外科病房常規手術前未停藥比率

Elective Surgeries through Multidisciplinary Collaboration in a Surgical Ward

手術前用藥評估攸關病人安全，術前正確停藥可以確保手術安全和避免術後併發症。本單位於2024年1月至3月間，常規手術臨時取消共有21件，其中手術前未停藥之比率高達57.1%，造成病人抱怨及護理人員工作負擔，故引發動機進行專案改善。本專案目的為降低外科病房常規手術前未停藥之比率。分析導致手術前未停藥之原因，包括醫護人員缺乏相關教育訓練、術前停藥宣導及衛教工具不足、及缺乏有效的術前用藥檢核機制。解決方案：辦理術前用藥實體及線上教育課程、製作術前停藥藥品公告及圖示化衛教單、製作術前停藥查詢APP、建置手術前麻醉訪視門診、增加術前用藥諮詢窗口。經專案實施後常規手術前未停藥之比率下降至19.2%。達成專案目標，提升病人手術及用藥安全，藉此專案成效提供臨床醫護人員參考。

Preoperative medication assessment is essential to patient safety. Correctly discontinuing medications before surgery ensures surgical safety and prevents postoperative complications. A total of 21 scheduled surgeries were cancelled during January to March 2024, with 57.1% resulting from not discontinuing medication properly before surgery. This contributed to patient complaints and nurse workload. The project aims to reduce preoperative medication non-discontinuation rate. Contributing factors to preoperative medication non-discontinuation include inadequate staff training, insufficient education tools, and lack of preoperative medication reconciliation process. Resolution: conduct in-person and on-line education sessions on preoperative medication management, developed educational material and illustrated handouts on preoperative medication discontinuation, created a mobile application to check preoperative medication, established pre-admission clinic for medication evaluation, and provided pre-operative medication consultation service. After implementation, the medication non-discontinuation rate prior to elective surgery decreased to 19.2%. This project effectively reduced preoperative medication non-discontinuation rate, enhancing both surgical and medication safety.