手術器械清潔之改善方案

Process Improvements for Cleaning Surgical Instruments

10.6142/VGHN.33.4.344

洪靖惇(Ching-Tun Hung)；蔡美惠(Mei-Hui Tsai)；李榮芬(Jung-Fen Lee)；呂芝慧(Jr-Huei Liu)；桑潁潁(Yiing-Yiing Sand)

手術器械 ； 滅菌品質 ； surgical instruments ； quality of sterilization

榮總護理

33卷4期（2016 / 12 / 01）

344 - 352

繁體中文

本專案目的在改善手術器械之潔淨度，以確保滅菌品質落實感染控制。當器械未確實清潔時不僅影響器械的使用壽命，也會造成滅菌不完全而引起手術部位的感染，專案前發現手術器械未洗淨件數每月平均為94 件 (0.54 %)，經現況分析發現導因有未預處理隔夜器械、廠借器械結構複雜且未規劃定期教育訓練、缺乏相關設備、省略標準作業流程及查核制度不夠完善等因素，予運用決策矩陣分析方法，擬定解決辦法為每月定期舉辦教育訓練課程、採購相關設備、增加人力、修訂標準作業流程及查核機制等，使專案實施後，2015 年1 月~ 4 月手術器械未洗淨之件數每月平均降至17 件 (0.09 %)，改善了手術器械之潔淨度，確保滅菌品質。

The purpose of this project was to improve the hygiene of surgical instruments to ensure sterilization quality and infection control. A lack of surgical instrument hygiene not only influences the service life of the instruments but also affects sterilization quality and can cause surgical-site infections. The average quantity of unclean surgical instruments measured before this project was 94 (0.54%) per month. After analysis, we determined this to be a result of instruments not being cleaned overnight, complicated procedures for loaning instruments, a lack of relevant equipment, insufficient training for nurses, failure to adhere to procedures, and inadequate checking guidelines. We adopted Decision Matrix Analysis as a method of evaluation and propose the following solutions: (1) monthly training programs for nurses, (2) purchasing relevant equipment, and (3) increasing the standards of operating procedures and checking guidelines. The average number of unclean surgical instruments decreased from 94 to 17 (0.09%) per month between January and April 2015. Hygiene of surgical instruments improved and quality of sterilization was ensured.

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