門診化學治療室病人化療前評估作業流程完整率之改善專案

A Project for Improving the Complete Rate of the Outpatient Pre-Chemotherapy Assessment Processes

10.3966/168395442014061401004

陳亞南(Ya-Nan Chen)；趙育玲(Yu-Ling Chao)；洪敏瑛(Ming-Ying Hong)

門診病人 ； 化學治療 ； 評估作業流程 ； outpatient ； chemotherapy ； assessment processes

腫瘤護理雜誌

14卷1期（2014 / 06 / 01）

35 - 47

繁體中文

門診化學治療（簡稱化療）是癌症治療新趨勢，兼顧醫療資源運用及病人社會角色功能。完整的化療前評估是維護病人安全主要策略之一，臨床實務發現化療前評估作業流程不完整，致使病人無法順利接受治療，除了影響病人安全，同時也造成化療藥物報廢之情形。2012年1月至5月有28筆報廢（報廢率21.9%），分析化療藥物報廢主要原因為化療前評估作業流程之完整率低（63.3%）。解決方案為制定化療前評估作業之標準作業流程、提升化療前身體評估紀錄單之完整性及落實化療病人電腦預約排程制度。經對策實施後門診執行化療前評估作業流程之完整率，由改善前的63.3%提升至100%；且化療藥物報廢率由21.9%降至0%，故對策實施除可維護病人安全，又可避免醫療資源之浪費。

Outpatient chemotherapy (abbreviated as chemotherapy) is a new trend in cancer treatment, which takes into account both the medical resource utilization and the social roles of patients. The main strategies to maintain patient safety is to complete the holistic assessment before chemotherapy. In clinical practice, we find that the incomplete evaluation processes before chemotherapy could lead to the difficulty of the patient treatment. In addition to affecting patient safety, it also led to scrapping the chemotherapy drugs. There were 28 scrapping events from January to May in 2012 (scrap rate of 21.9%). After analysis, it shows that the main cause of scrapping drugsis the low completion rate (63.3%) of the assessment before chemotherapy. The solutions are to developthe standard operating procedures for pre-chemotherapy assessment to enhance the completeness of pre-chemotherapy physical assessment doumentationand implement thecomputer schedule system for chemotherapy patients. After the solutions were implemented, the completion rate of outpatient pre-chemotherapy assessment improved from 63.3% to 100%, and the scrappingrate of chemotherapy drugs decreased to 0%. Therefore, the implementation of the solutions not only could maintain patient safety, but alsocould avoid scapping the medical resources.