提昇手術室移動式C-Arm X光機輻射防護完整性之改善專案

A Project to Improve the Integrity of Radiation Protection Measures of Portable X-ray Fluoroscopy in the Operating Room

詹菁馨(Ching-Hsin Chan)；蔡佳玲(Chia-Lin Tsai)；王琦(Chi Wang)；饒慧娟(Hui-Chuan Jao)；賀倫惠(Lun-Hui Ho)；戴秋玉(Chiu-Yu Dai)

手術室 ； 輻射防護措施 ； 標準作業 ； operating room ； radiation protection measures ； standard operation

志為護理-慈濟護理雜誌

17卷3期（2018 / 06 / 01）

87 - 100

繁體中文

醫用輻射於手術治療已被廣泛使用，手術團隊及病人因而暴露游離輻射危險中，做好輻射防護措施是很重要的。經現況分析發現手術室護理人員執行『移動式C-Arm X光機』輻射防護措施正確率低。原因為（一）護理人員輻射防護認知不足；（二）輻射防護設備不足；（三）缺乏定期教育訓練及管理輻射防護設備作業標準。專案小組採行解決辦法為：（一）辦理輻射防護教育訓練；（二）增購輻射防護設備；（三）制定輻射防護作業標準及查核制度。專案施行後，護理人員執行『移動式C-Arm X光機』輻射防護執行的正確率由50.5%提升至97.1%；輻射防護認知正確率由63%提升至98%。顯示本專案對提昇正確輻射防護成效具有正面意義，保障護理人員臨床工作環境安全，進而確保手術病人品質。

Portable fluoroscopy has been widely used during operation. The patients and the medical staff are at risk from radiation exposure when using portable radiography equipment. The purpose of this study is to propose an effective strategy to reduce radiation exposure. After adequate research into and verification of the nursing implementation of mobile C-arm fluoroscopic X-ray, the following problems were identified: 1) insufficient knowledge of radiation protection, 2) insufficient protection devices, and 3) lack of periodic education and protocol for the management of medical devices emitting ionizing radiation. The proposed improvement methods included periodic educational training program, the purchases of radiation protection devices, and the establishment of radiation protection standards and auditing system. After implementation of these strategies, the execution rate increased from 63% to 98%, and the correct cognition rate of radiation protection in staff increased from 50.5% to 97.1%. The results revealed a positive effect on accurate implementation of radiation protection, which ensures the clinical work environment safety of medical staff, and improvement in the quality of patient care.

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